Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain
Background: Chagas disease is an endemic protozoan disease with high prevalence in Latin America. Of those infected, 20–30% will develop chronic Chagas cardiomyopathy (CCC) however, prediction using existing clinical criteria remains poor. In this study, we investigated the utility of left ventricul...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722001099 |
| _version_ | 1828341103675310080 |
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| author | Sithu Win Monica Miranda-Schaeubinger Ronald Gustavo Durán Saucedo Paula Carballo Jimenez Jorge Flores Brandon Mercado-Saavedra Lola Camila Telleria Anne Raafs Manuela Verastegui Caryn Bern Freddy Tinajeros Stephane Heymans Rachel Marcus Robert H. Gilman Monica Mukherjee |
| author_facet | Sithu Win Monica Miranda-Schaeubinger Ronald Gustavo Durán Saucedo Paula Carballo Jimenez Jorge Flores Brandon Mercado-Saavedra Lola Camila Telleria Anne Raafs Manuela Verastegui Caryn Bern Freddy Tinajeros Stephane Heymans Rachel Marcus Robert H. Gilman Monica Mukherjee |
| author_sort | Sithu Win |
| collection | DOAJ |
| description | Background: Chagas disease is an endemic protozoan disease with high prevalence in Latin America. Of those infected, 20–30% will develop chronic Chagas cardiomyopathy (CCC) however, prediction using existing clinical criteria remains poor. In this study, we investigated the utility of left ventricular (LV) echocardiographic speckle-tracking global longitudinal strain (GLS) for early detection of CCC. Methods and results: 139 asymptomatic T. cruzi seropositive subjects with normal heart size and normal LV ejection fraction (EF) (stage A or B) were enrolled in this prospective observational study and underwent paired echocardiograms at baseline and 1-year follow-up. Progressors were participants classified as stage C or D at follow-up due to development of symptoms of heart failure, cardiomegaly, or decrease in LVEF. LV GLS was calculated as the average peak systolic strain of 16 LV segments. Measurements were compared between participants who progressed and did not progress by two-sample t-test, and the odds of progression assessed by multivariable logistic regression. Of the 139 participants, 69.8% were female, mean age 55.8 ± 12.5 years, with 12 (8.6%) progressing to Stage C or D at follow-up. Progressors tended to be older, male, with wider QRS duration. LV GLS was −19.0% in progressors vs. –22.4% in non-progressors at baseline, with 71% higher odds of progression per +1% of GLS (adjusted OR 1.71, 95% CI 1.20–2.44, p = 0.003). Conclusion: Baseline LV GLS in participants with CCC stage A or B was predictive of progression within 1-year and may guide timing of clinical follow-up and promote early detection or treatment. |
| first_indexed | 2024-04-13T23:08:54Z |
| format | Article |
| id | doaj.art-c3000531573a45f68002ec517e98fa9a |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-13T23:08:54Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-c3000531573a45f68002ec517e98fa9a2022-12-22T02:25:38ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-08-0141101060Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strainSithu Win0Monica Miranda-Schaeubinger1Ronald Gustavo Durán Saucedo2Paula Carballo Jimenez3Jorge Flores4Brandon Mercado-Saavedra5Lola Camila Telleria6Anne Raafs7Manuela Verastegui8Caryn Bern9Freddy Tinajeros10Stephane Heymans11Rachel Marcus12Robert H. Gilman13Monica Mukherjee14University of California San Francisco, San Francisco, CA, USA; Corresponding author.Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USAUniversidad Católica Boliviana San Pablo, BoliviaImperial College of London, UKUniversidad Católica Boliviana San Pablo, BoliviaDepartment of Biochemistry, University of Cambridge, UKPontificia Universidad Católica de Chile, Santiago, ChileMaastricht University, Cardiovascular Research Institute Maastricht (CARIM), Division of Cardiology, Maastricht, NetherlandsUniversidad Peruana Cayetano Heredia, Lima, PeruUniversity of California San Francisco, San Francisco, CA, USAUniversidad Católica Boliviana San Pablo, BoliviaMaastricht University, Cardiovascular Research Institute Maastricht (CARIM), Division of Cardiology, Maastricht, NetherlandsMedStar Heart & Vascular Institute, Baltimore, MD, USAJohns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins University, Division of Cardiology, Baltimore, MD, USABackground: Chagas disease is an endemic protozoan disease with high prevalence in Latin America. Of those infected, 20–30% will develop chronic Chagas cardiomyopathy (CCC) however, prediction using existing clinical criteria remains poor. In this study, we investigated the utility of left ventricular (LV) echocardiographic speckle-tracking global longitudinal strain (GLS) for early detection of CCC. Methods and results: 139 asymptomatic T. cruzi seropositive subjects with normal heart size and normal LV ejection fraction (EF) (stage A or B) were enrolled in this prospective observational study and underwent paired echocardiograms at baseline and 1-year follow-up. Progressors were participants classified as stage C or D at follow-up due to development of symptoms of heart failure, cardiomegaly, or decrease in LVEF. LV GLS was calculated as the average peak systolic strain of 16 LV segments. Measurements were compared between participants who progressed and did not progress by two-sample t-test, and the odds of progression assessed by multivariable logistic regression. Of the 139 participants, 69.8% were female, mean age 55.8 ± 12.5 years, with 12 (8.6%) progressing to Stage C or D at follow-up. Progressors tended to be older, male, with wider QRS duration. LV GLS was −19.0% in progressors vs. –22.4% in non-progressors at baseline, with 71% higher odds of progression per +1% of GLS (adjusted OR 1.71, 95% CI 1.20–2.44, p = 0.003). Conclusion: Baseline LV GLS in participants with CCC stage A or B was predictive of progression within 1-year and may guide timing of clinical follow-up and promote early detection or treatment.http://www.sciencedirect.com/science/article/pii/S2352906722001099Chagas diseaseChagas cardiomyopathyEchocardiographyStrain imaging |
| spellingShingle | Sithu Win Monica Miranda-Schaeubinger Ronald Gustavo Durán Saucedo Paula Carballo Jimenez Jorge Flores Brandon Mercado-Saavedra Lola Camila Telleria Anne Raafs Manuela Verastegui Caryn Bern Freddy Tinajeros Stephane Heymans Rachel Marcus Robert H. Gilman Monica Mukherjee Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain International Journal of Cardiology: Heart & Vasculature Chagas disease Chagas cardiomyopathy Echocardiography Strain imaging |
| title | Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain |
| title_full | Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain |
| title_fullStr | Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain |
| title_full_unstemmed | Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain |
| title_short | Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain |
| title_sort | early identification of patients with chagas disease at risk of developing cardiomyopathy using 2 d speckle tracking strain |
| topic | Chagas disease Chagas cardiomyopathy Echocardiography Strain imaging |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722001099 |
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