title: Evaluation of Right Ventricular Systolic Function in Chagas Disease Using Cardiac Magnetic Resonance Imaging.
abstract: Right ventricular (RV) impairment is postulated to be responsible for prominent systemic congestion in Chagas disease. However, occurrence of primary RV dysfunction in Chagas disease remains controversial. We aimed to study RV systolic function in patients with Chagas disease using cardiac magnetic resonance.
  
  
  
  This cross-sectional study included 158 individuals with chronic Chagas disease who underwent cardiac magnetic resonance. RV systolic dysfunction was defined as reduced RV ejection fraction based on predefined cutoffs accounting for age and sex. Multivariable logistic regression was used to verify the relationship of RV systolic dysfunction with age, sex, functional class, use of medications for heart failure, atrial fibrillation, and left ventricular systolic dysfunction. Mean age was 54±13 years, 51.2% men. RV systolic dysfunction was identified in 58 (37%) individuals. Although usually associated with reduced left ventricular ejection fraction, isolated RV systolic dysfunction was found in 7 (4.4%) patients, 2 of them in early stages of Chagas disease. Presence of RV dysfunction was not significantly different in patients with indeterminate/digestive form of Chagas disease (35.7%) compared with those with Chagas cardiomyopathy (36.8%) (P=1.000).
  
  
  
  In chronic Chagas disease, RV systolic dysfunction is more commonly associated with left ventricular systolic dysfunction, although isolated and early RV dysfunction can also be identified.
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Henrique T
authors.initials: HT
authors.lastname: Moreira
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Gustavo J
authors.initials: GJ
authors.lastname: Volpe
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: José A
authors.initials: JA
authors.lastname: Marin-Neto
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Bharath
authors.initials: B
authors.lastname: Ambale-Venkatesh
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Chike C
authors.initials: CC
authors.lastname: Nwabuo
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Henrique S
authors.initials: HS
authors.lastname: Trad
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Minna M D
authors.initials: MM
authors.lastname: Romano
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Antonio
authors.initials: A
authors.lastname: Pazin-Filho
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: Benedito C
authors.initials: BC
authors.lastname: Maciel
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.).
authors.forename: João A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: From the Department of Internal Medicine, Divisions of Cardiology and Radiology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (H.T.M., G.J.V., J.A.M.-N., H.S.T., M.M.D.R., A.P.-F., B.C.M., A.S.); and Department of Cardiovascular Imaging, Johns Hopkins University, Baltimore, MD (B.A.-V., C.C.N., J.A.C.L.). aschmidt@fmrp.usp.br.
authors.forename: André
authors.initials: A
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D000368:Aged; D002598:Chagas Cardiomyopathy / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005355:Fibrosis; D006801:Humans; D016015:Logistic Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
keywords: Chagas cardiomyopathy; atrial fibrillation; heart failure; magnetic resonance imaging; systole