Romero Acero Laura-M, Gallego Ardila Andrés-D, Nanna Michele, Manrique Espinel Frida T, Medina Héctor M, Sciarresi Esteban, Tabares-Mora Fabio-A, Sanchez Alejandro Olaya, Ayala Carolina, Fajardo Ruge Jorge L, Medina-Mur Ramón, Vargas Vergara Diana, Salazar Castro Gabriel, Díaz Andrés
Cardiology Department, Hospital de San José, Fundación Universitaria de Ciencias de la Salud-FUCS, 110321 Bogota, Colombia.
Research Department, Hospital de San José, Fundación Universitaria de Ciencias de la Salud-FUCS, 110321 Bogota, Colombia.
Rev Cardiovasc Med. 2022 Sep 16;23(9):323. doi: 10.31083/j.rcm2309323. eCollection 2022 Sep.
Chagas cardiomyopathy (CC) increases cardiovascular mortality associated with congestive heart failure (CHF), ventricular arrhythmias (VA), and sudden cardiac death (SCD). Different imaging techniques have been tested to assess disease progression and cardiac risk in individuals with Chagas disease (ChD). In this systematic review, we evaluated the accuracy in detecting cardiac complications in CC patients using cardiac magnetic resonance (CMR) and speckle tracking echocardiography (STE).
A search was done on PubMed, Cochrane, and Embase for studies in humans over 18 years of age with ChD. Demographic data, research methodology, imaging parameters, and cardiac outcomes were extracted, and study quality was assessed, resulting in a narrative description.
Twelve studies with 1124 patients were analyzed. One study discovered a contractility pattern by STE. Four studies assessed the identification of Early Cardiac Impairment (ECI) and VA risk, respectively, while three studies evaluated the risk of SCD. Global Longitudinal Strain (GLS) identified patients with ECI (-18.5 3.4% non-fibrosis vs -14.0 5.8% fibrosis, = 0.006 and -18 2% non-fibrosis vs -15 2% fibrosis, = 0.004). The amount of fibrosis 11.78% or in two or more contiguous transmural segments were markers for VA risk. GLS and the amount of fibrosis were found to be predictors of SCD.
STE may be considered a screening technique for identifying the subclinical status of CHF. CMR using Late Gadolinium Enhancement (LGE) is considered a relevant parameter for stratifying patients with ChD who are at risk of SCD. Fibrosis and GLS can be used as markers to categorize patients at risk for arrhythmias.
恰加斯心肌病（CC）会增加与充血性心力衰竭（CHF）、室性心律失常（VA）和心源性猝死（SCD）相关的心血管死亡率。已对不同的成像技术进行测试，以评估恰加斯病（ChD）患者的疾病进展和心脏风险。在本系统评价中，我们评估了使用心脏磁共振成像（CMR）和斑点追踪超声心动图（STE）检测CC患者心脏并发症的准确性。
在PubMed、Cochrane和Embase数据库中检索针对18岁以上ChD患者的研究。提取人口统计学数据、研究方法、成像参数和心脏结局，并评估研究质量，形成叙述性描述。
分析了12项研究，共1124例患者。一项研究通过STE发现了一种收缩模式。四项研究分别评估了早期心脏损伤（ECI）的识别和VA风险，三项研究评估了SCD风险。整体纵向应变（GLS）可识别出ECI患者（非纤维化组为-18.5±3.4%，纤维化组为-
