title: Myocardial perfusion imaging and cardiac involvement in the indeterminate phase of Chagas disease.
abstract: BACKGROUND
  Myocardial perfusion imaging (MPI) has been used in the assessment of chagasic heart disease.
  
  
  OBJECTIVE
  To investigate the value of gated-single photon emission computed tomography (gated-SPECT) MPI to detect early cardiac involvement in chagasic patients in the indeterminate phase, who present segmental motion abnormalities detected by tissue Doppler imaging (TDI)-derived strain.
  
  
  METHODS
  Forty individuals (mean age: 25±2 years, 50% males) from an endemic area of Chagas disease and with positive serologic diagnosis, were included. All underwent gated-SPECT two-day (stress-rest) MPI and echocardiography.
  
  
  RESULTS
  Thirty individuals (75%) showed a normal scan. In three cases (8%) the MPI was slightly abnormal, and in seven it was equivocal. In all cases with reversible defects, the affected segments were coincident with those with motion abnormalities. A post-stress left ventricular ejection fraction (LVEF) reduction > 5% (ΔLVEF < -5%) was found in 11 out of 40 individuals (28%). Both the phase-derived standard deviation and the histogram bandwidth showed a significant difference between post-stress and rest. In both cases there was a slight dyssynchrony at rest which normalized at post-stress.
  
  
  CONCLUSIONS
  A stress-rest gated-SPECT is a valid approach to detect early myocardial alterations, as well as intraventricular dyssynchrony in the indeterminate phase of Chagas disease in patients with segmental motion abnormalities previously detected by TDI-derived strain.
authors.affiliation: Institute of Cardiology, La Habana, Cuba. peix@infomed.sld.cu
authors.forename: Amalia
authors.initials: A
authors.lastname: Peix
authors.forename: Raymid
authors.initials: R
authors.lastname: García
authors.forename: Jesús
authors.initials: J
authors.lastname: Sánchez
authors.forename: Lázaro O
authors.initials: LO
authors.lastname: Cabrera
authors.forename: Kenia
authors.initials: K
authors.lastname: Padrón
authors.forename: Oscar
authors.initials: O
authors.lastname: Vedia
authors.forename: Hugo V
authors.initials: HV
authors.lastname: Choque
authors.forename: Jorge
authors.initials: J
authors.lastname: Fraga
authors.forename: Juan
authors.initials: J
authors.lastname: Bandera
authors.forename: Alberto
authors.initials: A
authors.lastname: Hernández-Cañero
mesh_terms: D000328:Adult; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D002598:Chagas Cardiomyopathy / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016009:Chi-Square Distribution; D042241:Early Diagnosis; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D019275:Radiopharmaceuticals; D018709:Statistics, Nonparametric; D017256:Technetium Tc 99m Sestamibi; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi