Salomone O A, Caeiro T
Hospital Privado-Centro Médico de Córdoba, Argentina.
Medicina (B Aires). 1996;56(6):690-8.
The aim of the present study was to carry out a quantitative assessment of the regional left ventricular wall motion and diastolic function of patients with Chagas disease in different clinical stages. Twenty patients with positive immunofluorescence tests for Chagas disease were studied. Eight patients were asymptomatic (class I), 9 patients had electrocardiographic abnormalities (class II) and 3 patients had heart failure (class III). The control group consisted of 10 normal subjects. 2D echocardiographic images from parasternal and apical views were analysed quantitatively using a previously validated method for the assessment of the regional wall motion of the left ventricle. Diastolic flow velocities and times at mitral valve level were analysed using pulsed wave Doppler. Patients with Chagas disease showed marked wall motion abnormalities in the posterobasal segment compared with controls. These abnormalities were evident even in class I patients. The number of affected segments was higher in class II and class III. "A" wave velocity was greater in patients than in controls (0.67 +/- 0.17 and 0.49 +/- 0.08 m/s, p = 0.01 respectively) but the pattern of diastolic flow velocity was non specific. In conclusion, regional left ventricular wall motion abnormalities are common in early stages of Chagas disease suggesting that myocardial activity of the disease is present even during the asymptomatic period.
本研究的目的是对处于不同临床阶段的恰加斯病患者的左心室壁节段运动及舒张功能进行定量评估。研究了20名恰加斯病免疫荧光检测呈阳性的患者。其中8名患者无症状（I级），9名患者有心电图异常（II级），3名患者有心力衰竭（III级）。对照组由10名正常受试者组成。使用先前验证的评估左心室壁节段运动的方法，对胸骨旁和心尖视图的二维超声心动图图像进行定量分析。使用脉冲波多普勒分析二尖瓣水平的舒张期流速和时间。与对照组相比，恰加斯病患者的后基底段存在明显的壁运动异常。这些异常在I级患者中也很明显。II级和III级患者中受影响节段的数量更多。患者的“A”波速度高于对照组（分别为0.67±0.17和0.49±0.08 m/s，p = 0.01），但舒张期流速模式无特异性。总之，左心室壁节段运动异常在恰加斯病早期很常见，这表明即使在无症状期，该病的心肌活动也已存在。
