TY - JOUR
T1 - Cardiac magnetic resonance imaging in Chagas’ disease
T2 - a parallel with electrophysiologic studies
AU - Duran-Crane, Alejandro
AU - Rojas, Carlos A.
AU - Cooper, Leslie T.
AU - Medina, Hector M.
N1 - Publisher Copyright:
© 2020, Springer Nature B.V.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Chagas’ disease (CD), caused by the parasite Trypanosoma cruzi, is the leading cause of cardiac disability from infectious diseases in Central and South America. The disease progresses through an extended, asymptomatic form characterized by latency without clinical manifestations into a symptomatic form with cardiac and gastro-intestinal manifestations. In the terminal phase, chronic Chagas’ myocarditis results in extensive myocardial fibrosis, chamber enlargement with aneurysms and ventricular tachycardia (VT). Cardiac magnetic resonance imaging (CMR) has proven useful in characterizing myocardial fibrosis (MF). Sub-epicardial and mid-wall fibrosis are less common patterns of MF in CHD than transmural scar, which resembles myocardial infarction. Commonly involved areas of MF include the left ventricular apex and basal infero-lateral wall, suggesting a role for watershed ischemia in the pathophysiology of MF. Electrophysiology studies have helped refine the relationship between MF and VT in this setting. This article reviews the patterns of MF in CHD and correlate these patterns with electrogram patterns to predict risk of ventricular arrhythmias and sudden death.
AB - Chagas’ disease (CD), caused by the parasite Trypanosoma cruzi, is the leading cause of cardiac disability from infectious diseases in Central and South America. The disease progresses through an extended, asymptomatic form characterized by latency without clinical manifestations into a symptomatic form with cardiac and gastro-intestinal manifestations. In the terminal phase, chronic Chagas’ myocarditis results in extensive myocardial fibrosis, chamber enlargement with aneurysms and ventricular tachycardia (VT). Cardiac magnetic resonance imaging (CMR) has proven useful in characterizing myocardial fibrosis (MF). Sub-epicardial and mid-wall fibrosis are less common patterns of MF in CHD than transmural scar, which resembles myocardial infarction. Commonly involved areas of MF include the left ventricular apex and basal infero-lateral wall, suggesting a role for watershed ischemia in the pathophysiology of MF. Electrophysiology studies have helped refine the relationship between MF and VT in this setting. This article reviews the patterns of MF in CHD and correlate these patterns with electrogram patterns to predict risk of ventricular arrhythmias and sudden death.
KW - Chagas’ heart disease
KW - Magnetic resonance imaging
KW - Myocardial fibrosis
KW - Radiofrequency ablation
KW - Ventricular arrhythmias
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U2 - 10.1007/s10554-020-01925-2
DO - 10.1007/s10554-020-01925-2
M3 - Review article
C2 - 32613382
AN - SCOPUS:85087411399
SN - 1569-5794
VL - 36
SP - 2209
EP - 2219
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 11
ER -