IMR Press / RCM / Volume 23 / Issue 9 / DOI: 10.31083/j.rcm2309323
Open Access Systematic Review
Late Gadolinium Enhancement by Cardiac Magnetic Resonance and Speckle Tracking Echocardiography in the Evaluation of Cardiac Complications in Chagas Cardiomyopathy: A Systematic Review
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1 Cardiology Department, Hospital de San José, Fundación Universitaria de Ciencias de la Salud-FUCS, 110321 Bogota, Colombia
2 Research Department, Hospital de San José, Fundación Universitaria de Ciencias de la Salud-FUCS, 110321 Bogota, Colombia
3 Cardiology Department, Albert Einstein Hospital, Albert Einstein College of Medicine, Bronx, NY 10461, USA
4 Non-invasive methods Department, Universidad del Rosario, La Cardio-Fundación Cardio-infantil, 110131 Bogota, Colombia
5 Cardiovascular Diagnostic Imaging Department, Universidad del Rosario, La Cardio-Fundación Cardio-infantil, 110131 Bogota, Colombia
6 Cardiology Department, Universidad Abierta Interamericana Rosario, Instituto de Cardiología de San Nicolás, 2900 San Nicolás De Los Arroyos, Buenos Aires, Argentina
7 Cardiology Department, Universidad del Bosque, La Cardio-Fundación Cardio-infantil, 110131 Bogota, Colombia
*Correspondence: lauramarh@gmail.com (Laura-M Romero Acero)
Academic Editor: Jerome L. Fleg
Rev. Cardiovasc. Med. 2022, 23(9), 323; https://doi.org/10.31083/j.rcm2309323
Submitted: 6 May 2022 | Revised: 2 July 2022 | Accepted: 11 August 2022 | Published: 16 September 2022
(This article belongs to the Section Heart Diseases)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: 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). Methods: 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. Results: 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, p = 0.006 and –18 ± 2% non-fibrosis vs –15 ± 2% fibrosis, p = 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. Conclusions: 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.

Keywords
Chagas disease
Chagas cardiomyopathy
magnetic resonance imaging
speckle tracking echocardiography
Figures
Fig. 1.
Funding
749-2016/ Ministry of Science of Colombia (MINCIENCIAS)
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