title: Value of cardiac MRI for evaluation of chronic Chagas disease cardiomyopathy.
abstract: OBJECTIVE
  To determine whether cardiac magnetic resonance imaging (cMRI) is more sensitive than electrocardiogram (ECG) and echocardiogram (ECHO) for detecting myocardial involvement in a Latin American migrant population with untreated Chagas disease (CD) in the United States.
  
  
  METHODS
  All untreated CD patients with ECG and ECHO examinations who underwent cMRI at Olive View-UCLA Medical Center from September 2010 to December 2013 (n=81) were analysed in three groups: Group 1, normal ECG and ECHO examinations (n=50); Group 2, abnormal ECG and normal ECHO examinations (n=10); and Group 3, abnormal ECHO examination (n=21). Frequencies of ECG, ECHO, and cMRI findings were compared across groups.
  
  
  RESULTS
  Seventy percent (57/81) of the study population was female, with a mean age of 47 years (range, 17-77 years). Twenty-six percent (21/81) had delayed myocardial enhancement (DME), which was most commonly inferolateral in location (27%, 32/117 segments) and transmural in pattern (56%, 65/117 segments). Eight percent (4/50), 30% (3/10), and 67% (14/21) of Groups 1-3, respectively, had DME. Of these individuals with DME, 50% (2/4), 67% (2/3), and 100% (14/14) of Groups 1-3, respectively, also had wall motion abnormality (WMA) on cMRI. In addition to the highest percentages of DME and WMA, Group 3 also had significantly higher mean myocardial mass (p<0.01), mean left ventricular end-diastolic (p<0.01) and end-systolic volumes (p<0.0005), and significantly lower mean left ventricular ejection fraction (p<0.001).
  
  
  CONCLUSIONS
  cMRI may detect myocardial involvement in untreated CD that is otherwise unrecognised on ECG and ECHO.
authors.affiliation: Department of Radiological Sciences, Ronald Reagan-UCLA Medical Center, United States. Electronic address: stlee@mednet.ucla.edu.
authors.forename: S A
authors.initials: SA
authors.lastname: Lee-Felker
authors.affiliation: Department of Radiological Sciences, Olive View-UCLA Medical Center- Center of Excellence for Chagas Disease, United States.
authors.forename: M
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Department of Radiological Sciences, Ronald Reagan-UCLA Medical Center, United States.
authors.forename: E R
authors.initials: ER
authors.lastname: Felker
authors.affiliation: Department of Cardiology, Olive View-UCLA Medical Center- Center of Excellence for Chagas Disease, United States.
authors.forename: M
authors.initials: M
authors.lastname: Traina
authors.affiliation: Department of Cardiology, Olive View-UCLA Medical Center- Center of Excellence for Chagas Disease, United States.
authors.forename: M
authors.initials: M
authors.lastname: Salih
authors.affiliation: Department of Cardiology, Olive View-UCLA Medical Center- Center of Excellence for Chagas Disease, United States.
authors.forename: S
authors.initials: S
authors.lastname: Hernandez
authors.affiliation: Department of Cardiology, Olive View-UCLA Medical Center- Center of Excellence for Chagas Disease, United States.
authors.forename: J
authors.initials: J
authors.lastname: Bradfield
authors.affiliation: Department of Radiological Sciences, Olive View-UCLA Medical Center- Center of Excellence for Chagas Disease, United States.
authors.forename: M
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Olive View-UCLA Medical Center- Center of Excellence for Chagas Disease, United States.
authors.forename: S
authors.initials: S
authors.lastname: Meymandi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002598:Chagas Cardiomyopathy / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology; D055815:Young Adult