title: Histopathological Correlates of Global and Segmental Left Ventricular Systolic Dysfunction in Experimental Chronic Chagas Cardiomyopathy.
abstract: BACKGROUND
  Chronic Chagas cardiomyopathy in humans is characterized by segmental left ventricular wall motion abnormalities (WMA), mainly in the early stages of disease. This study aimed at investigating the detection of WMA and its correlation with the underlying histopathological changes in a chronic Chagas cardiomyopathy model in hamsters.
  
  
  RESULTS
  Female Syrian hamsters (n=34) infected with 3.5×10(4) or 10(5) blood trypomastigote Trypanosoma cruzi (Y strain) forms and an uninfected control group (n=7) were investigated. After 6 or 10 months after the infection, the animals were submitted to in vivo evaluation of global and segmental left ventricular systolic function by echocardiography, followed by euthanasia and histological analysis for quantitative assessment of fibrosis and inflammation with tissue sampling in locations coinciding with the left ventricular wall segmentation employed at the in vivo echocardiographic evaluation. Ten of the 34 infected animals (29%) showed reduced left ventricular ejection fraction (<73%). Left ventricular ejection fraction was more negatively correlated with the intensity of inflammation (r=-0.63; P<0.0001) than with the extent of fibrosis (r=-0.36; P=0.036). Among the 24 animals with preserved left ventricular ejection fraction (82.9±5.5%), 8 (33%) showed segmental WMA predominating in the apical, inferior, and posterolateral segments. The segments exhibiting WMA, in comparison to those with normal wall motion, showed a greater extent of fibrosis (9.3±5.7% and 7±6.3%, P<0.0001) and an even greater intensity of inflammation (218.0±111.6 and 124.5±84.8 nuclei/mm², P<0.0001).
  
  
  CONCLUSIONS
  Isolated WMA with preserved global systolic left ventricular function is frequently found in Syrian hamsters with experimental chronic Chagas cardiomyopathy whose underlying histopathological features are mainly inflammatory.
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Luciano Fonseca Lemos
authors.initials: LF
authors.lastname: de Oliveira
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Minna Moreira Dias
authors.initials: MM
authors.lastname: Romano
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Eduardo Elias Vieira
authors.initials: EE
authors.lastname: de Carvalho
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil (J.M.C.).
authors.forename: Jorge Mejia
authors.initials: JM
authors.lastname: Cabeza
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Hélio Cesar
authors.initials: HC
authors.lastname: Salgado
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Rubens
authors.initials: R
authors.lastname: Fazan Júnior
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Renata Sesti
authors.initials: RS
authors.lastname: Costa
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: João Santana
authors.initials: JS
authors.lastname: da Silva
authors.affiliation: Heart Institute (InCor), Faculty of Medicine, University of Sao Paulo, Brazil (M.L.H., E.C.N.).
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Higuchi
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Benedito Carlos
authors.initials: BC
authors.lastname: Maciel
authors.affiliation: Heart Institute (InCor), Faculty of Medicine, University of Sao Paulo, Brazil (M.L.H., E.C.N.).
authors.forename: Edécio
authors.initials: E
authors.lastname: Cunha-Neto
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: José Antônio
authors.initials: JA
authors.lastname: Marin-Neto
authors.affiliation: Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil (L.F.L.O., M.M.D.R., E.E.V.C., C.S., R.F.J., R.S.C., J.S.S., B.C.M., J.A.M.N., M.V.S.).
authors.forename: Marcus Vinícius
authors.initials: MV
authors.lastname: Simões
mesh_terms: D000818:Animals; D002598:Chagas Cardiomyopathy / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology* / Q000503:physiopathology; D002908:Chronic Disease; D004195:Disease Models, Animal; D015150:Echocardiography, Doppler; D005260:Female; D005355:Fibrosis; D008647:Mesocricetus; D009206:Myocardium / Q000473:pathology*; D013318:Stroke Volume; D013599:Systole; D013997:Time Factors; D014349:Trypanosoma cruzi / Q000472:pathogenicity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: Chagas heart failure; echocardiography; pathology