scholarly journals Cardiovascular findings by echocardiography in canine model of Chagas disease immunized with DNA Trypanosoma cruzi genes.

2019 ◽  
Author(s):  
Olivia Rodríguez-Morales ◽  
Francisco-Javier Roldán ◽  
Jesús Vargas-Barrón ◽  
Enrique Parra-Benítez ◽  
María de Lourdes Medina-García ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Ventricular Volume ◽  
Canine Model ◽  
Pathological Process ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Time ◽  
Ventricular Ejection Fraction ◽  
The Usa

Abstract Background: Chagas disease (ChD) is nowadays considered as an emerging disease in the USA and Europe. pBCSP and pBCSSP4 plasmids, containing Trypanosoma cruzi genes encoding a trans -sialidase protein and an amastigote-specific glycoprotein, respectively, were tested as vaccines in canine model. Echocardiography studies for determining the prophylactic effect of these genes in experimentally infected dogs were evaluated to compare with findings obtained by other techniques performed previously. Hemodynamic parameters after DNA-immunization were performed. Results: Low fractional-shortening values of non-vaccinated dogs suggested an impairment in general cardiac function. Low Left-Ventricular-Ejection-Fraction values found in infected dogs suggested myocardial injury regardless of whether they were vaccinated or not. Low Left-Ventricular-Diastolic/Systolic-Diameters in vaccinated dogs suggested that progressive heart damage or heart dilation could be prevented by DNA vaccination. Systolic-Peak-Time was higher in non-vaccinated groups increasing vulnerability to malignant arrhythmias and sudden death. High Left-Ventricular-Volume in infected groups suggested a decrease in wall thickness that might lead to increased size of the heart cavity, except in the pBCSP plasmid-vaccinated dogs. Conclusions: The use of echocardiography allowed a more complete follow-up the pathological process in the living patient than with other techniques like electrocardiography, anatomopathology and histopathology, being the method of choice for characterizing the clinical stages of ChD.

scholarly journals Echocardiographic Findings in Canine Model of Chagas Disease Immunized with DNA Trypanosoma cruzi Genes

Animals ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 648
Author(s):  
Olivia Rodríguez-Morales ◽  
Francisco-Javier Roldán ◽  
Jesús Vargas-Barrón ◽  
Enrique Parra-Benítez ◽  
María de Lourdes Medina-García ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Systolic Function ◽  
Ventricular Volume ◽  
Canine Model ◽  
Pathological Process ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Time ◽  
Ventricular Ejection Fraction

Chagas disease (ChD) is considered an emerging disease in the USA and Europe. Trypanosoma cruzi genes encoding a trans-sialidase protein and an amastigote-specific glycoprotein were tested as vaccines in canine model. The aim for this study was determining the prophylactic effect of these genes in experimentally infected dogs by echocardiography evaluation to compare with our findings obtained by other techniques published previously. Low fractional-shortening values of non-vaccinated dogs suggested an impairment in general cardiac function. Low left ventricular ejection fraction values found in infected dogs suggested myocardial injury regardless of whether they were vaccinated. Low left ventricular diastolic/systolic diameters suggested that progressive heart damage or heart dilation could be prevented by DNA vaccination. Systolic peak time was higher in non-vaccinated groups, increasing vulnerability to malignant arrhythmias and sudden death. High left ventricular volume suggested a decrease in wall thickness that might lead to increased size of the heart cavity, except in the pBCSP plasmid-vaccinated dogs. There was an echocardiographic evidence of left ventricular dilation and reduction in systolic function in experimental chagasic dogs. Echocardiography allowed a more complete follow-up of the pathological process in the living patient than with other techniques like electrocardiography, anatomopathology, and histopathology, being the method of choice for characterizing the clinical stages of ChD.

Incidence and Predictors of Progression to Chagas Cardiomyopathy: Long-Term Follow-Up of Trypanosoma Cruzi Seropositive Individuals

Circulation ◽  
2021 ◽  
Author(s):  
Maria Carmo P. Nunes ◽  
Lewis F. Buss ◽  
Jose Luiz P. da Silva ◽  
Larissa Natany Almeida Martins ◽  
Claudia Di Lorenzo Oliveira ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Clinical Epidemiology ◽  
Outpatient Service ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Blood Collection ◽  
Ventricular Ejection Fraction ◽  
Chagas Cardiomyopathy

Background: There are few contemporary cohorts of Trypanosoma cruzi -seropositive individuals, and the basic clinical epidemiology of Chagas disease is poorly understood. Herein, we report the incidence of cardiomyopathy and death associated with T. cruzi seropositivity. Methods: Participants were selected in blood banks at 2 Brazilian centers. Cases were defined as T. cruzi -seropositive blood donors. T. cruzi -seronegative controls were matched for age, sex, and period of donation. Patients with established Chagas cardiomyopathy were recruited from a tertiary outpatient service. Participants underwent medical examination, blood collection, electrocardiogram, and echocardiogram at enrollment (2008 to 2010) and at follow-up (2018 to 2019). The primary outcomes were all-cause mortality and development of cardiomyopathy, defined as the presence of a left ventricular ejection fraction <50% and/or QRS complex duration ≥ 120 ms. To handle loss to follow-up, a sensitivity analysis was performed using inverse probability weights for selection. Results: We enrolled 499 T. cruzi -seropositive donors (age 48 ± 10 years, 52% male), 488 T. cruzi -seronegative donors (age 49 ± 10 years, 49% male), and 101 patients with established Chagas cardiomyopathy (age 48 ± 8 years, 59% male). The mortality in patients with established cardiomyopathy was 80.9 deaths/1000 person-years (py) (54/101, 53%) and 15.1 deaths/1000py (17/114, 15%) in T. cruzi -seropositives with cardiomyopathy at baseline. Among T. cruzi -seropositive donors without cardiomyopathy at baseline mortality was 3.7 events/1000py (15/385, 4%), which was no different from T. cruzi -seronegative donors with 3.6 deaths/1000py (17/488, 3%). The incidence of cardiomyopathy in T. cruzi -seropositive donors was 13.8 (95% CI 9.5-19.6) events/1000py (32/262, 12%) compared with 4.6 (95% CI 2.3-8.3) events/1000 py (11/277, 4%) in seronegative controls, with an absolute incidence difference associated with T. cruzi seropositivity of 9.2 (95% CI 3.6 - 15.0) events/1000py. T. cruzi antibody level at baseline was associated with development of cardiomyopathy (adjusted OR of 1.4, 95% CI 1.1-1.8). Conclusions: We present a comprehensive description of the natural history of T. cruzi seropositivity in a contemporary patient population. The results highlight the central importance of anti- T. cruzi antibody titer as a marker of Chagas disease activity and risk of progression.

scholarly journals Effects of peak time of myocardial injury biomarkers on mid-term outcomes of patients undergoing OPCABG

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Hu ◽  
Fei Gao ◽  
Mengwei Lv ◽  
Ban Liu ◽  
Yu Shi ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Cox Regression ◽  
Troponin T ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Time ◽  
Clinical Trial Registry ◽  
Ventricular Ejection Fraction ◽  
The Impact

Abstract Background With the development of cardiac surgery techniques, myocardial injury is gradually reduced, but cannot be completely avoided. Myocardial injury biomarkers (MIBs) can quickly and specifically reflect the degree of myocardial injury. Due to various reasons, there is no consensus on the specific values of MIBs in evaluating postoperative prognosis. This retrospective study was aimed to investigate the impact of MIBs on the mid-term prognosis of patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Totally 564 patients undergoing OPCABG with normal courses were included. Cardiac troponin T (cTnT) and creatine kinase myocardial band (CK-MB) were assessed within 48 h before operation and at 6, 12, 24, 48, 72, 96 and 120 h after operation. Patients were grouped by peak values and peak time courses of MIBs. The profile of MIBs and clinical variables as well as their correlations with mid-term prognosis were analyzed by univariable and multivariable Cox regression models. Result Continuous assessment showed that MIBs increased first (12 h after surgery) and then decreased. The peak cTnT and peak CK-MB occurred within 24 h after operation in 76.8% and 67.7% of the patients respectively. No significant correlation was found between CK-MB and mid-term mortality. Delayed cTnT peak (peak cTnT elevated after 24 h after operation) was correlated with lower creatinine clearance rate (69.36 ± 21.67 vs. 82.18 ± 25.17 ml/min/1.73 m2), body mass index (24.35 ± 2.58 vs. 25.27 ± 3.26 kg/m2), less arterial grafts (1.24 ± 0.77 vs. 1.45 ± 0.86), higher EuroSCORE II (2.22 ± 1.12 vs.1.72 ± 0.91) and mid-term mortality (26.5 vs.7.9%). Age (HR: 1.067, CI: 1.006–1.133), left ventricular ejection fraction (HR: 0.950, CI: 0.910–0.993), New York Heart Association score (HR: 1.839, CI: 1.159–2.917), total venous grafting (HR: 2.833, CI: 1.054–7.614) and cTnT peak occurrence within 24 h (HR: 0.362, CI: 0.196–0.668) were independent predictors of mid-term mortality. Conclusion cTnT is a better indicator than CK-MB. The peak value and peak occurrence of cTnT are related to mid-term mortality in patients undergoing OPCABG, and the peak phases have stronger predictive ability. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000033850. Registered 14 June 2020, http://www.chictr.org.cn/edit.aspx?pid=55162&htm=4.

The Assessment of Left Ventricular Ejection Fraction in Patients with Ischaemic Heart Disease by Contrast Ventriculography and Nuclear Angiography

1977 ◽  
Vol 53 (1) ◽  
pp. 55-61 ◽  
Author(s):  
A. L. Muir ◽  
W. J. Hannan ◽  
H. M. Brash ◽  
V. Baldwa ◽  
H. C. Miller ◽  
...  
Keyword(s):  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Ischaemic Heart Disease ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Contrast Ventriculography

1. In 18 patients with ischaemic heart disease left ventricular ejection fraction, measured by two different nuclear angiographic methods, has been compared with ejection fraction measured by single-plane contrast angiography. 2. The first nuclear angiographic technique involves detection of variation in the radioactivity from the left ventricle during the initial passage of a bolus of 99Tcm-labelled human serum albumin injected intravenously; the second is our own modification of a ‘gated’ method, which accumulates the radioactivity detected during the continuing recirculation of the plasma bound radioisotope, so presenting an ‘averaged’ ventricular volume curve. 3. Ejection fraction, measured by the ‘bolus’ method, is lower than that measured either by contrast ventriculography or by the ‘gated’ method. This may be due to a damping effect. 4. Ejection fraction measured by the ‘gated’ method is well correlated with that measured by contrast ventriculography (r = 0·89). 5. Our modification of the ‘gated’ method, which presents the changes in ventricular volume throughout the cardiac cycle, without needing computer facilities, is a useful non-invasive means for assessment of left ventricular function.

scholarly journals Prospective Analysis of Myocardial Strain Through Evolution of Chagas Disease in the Hamster Animal Model

2021 ◽  
Author(s):  
Fernando F.F. Ribeiro ◽  
Henrique T. Moreira ◽  
Antônio C.L. Barros-Filho ◽  
Denise M Tanaka ◽  
Camila G. Fabricio ◽  
...  
Keyword(s):  
Animal Model ◽  
Chagas Disease ◽  
Myocardial Strain ◽  
Chronic Phase ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Saline Control ◽  
P Value ◽  
Ventricular Ejection Fraction ◽  
Time Interaction

Abstract Background: Speckle tracking echocardiography (STE) enables early diagnosis of myocardial damage by evaluating myocardial strain. We aimed to study sequential changes in structural and functional ventricular parameters during Chagas disease (CD) natural history in an animal model. Methods: 37 Syrian hamsters were inoculated intraperitoneally with Trypanosoma cruzi (Chagas) and 20 with saline (Control). Echocardiography was performed before the infection (baseline), at 1month (acute phase), 4, 6 and 8 months (chronic phase) using Vevo 2100 (Fujifilm Inc.) ultrasound system. Left ventricular end-diastolic diameter (LVEDD), end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), global longitudinal (GLS), circumferential (GCS) and radial (GRS) strain were evaluated. Tricuspid annular plane systolic excursion (TAPSE) was used to assess right ventricular function. At 8 months, animals were euthanized and LV myocardial samples were analyzed for quantitation of inflammation and fibrosis. Results: LVEF decreased over time in Chagas group and a difference from Control was detected at 6 months (p-value of groups#time interaction = 0.005). There was a pronounced decrease in GLS, GCS and TAPSE in Chagas group (p-value of groups#time interaction = 0.003 for GLS, < 0.001 for GCS and < 0.009 for TAPSE vs Control) since the first month. LVESD, LVEF and GLS were significantly correlated to the number of inflammatory cells (r= 0.41, p=0.046; r= -0.42, p=0.042; r=0.41, p=0.047) but not to fibrosis. Conclusions: In the Syrian hamster model of CD STE parameters (GLS and GCS) showed an early decrease. Changes in LVEF, LVESD and GLS were correlated to myocardial inflammation but not to fibrosis.

scholarly journals Prospective analysis of myocardial strain through the evolution of Chagas disease in the hamster animal model

2021 ◽  
Author(s):  
Fernando Fonseca França Ribeiro ◽  
Henrique Turin Moreira ◽  
Antônio Carlos Leite de Barros-Filho ◽  
Denise M. Tanaka ◽  
Camila G. Fabricio ◽  
...  
Keyword(s):  
Animal Model ◽  
Chagas Disease ◽  
Myocardial Strain ◽  
Chronic Phase ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Saline Control ◽  
P Value ◽  
Ventricular Ejection Fraction ◽  
Time Interaction

AbstractSpeckle tracking echocardiography (STE) enables early diagnosis of myocardial damage by evaluating myocardial strain. We aimed to study sequential changes in structural and ventricular functional parameters during Chagas disease (CD) natural history in an animal model. 37 Syrian hamsters were inoculated intraperitoneally with Trypanosoma cruzi (Chagas) and 20 with saline (Control). Echocardiography was performed before the infection (baseline), at 1 month (acute phase), 4, 6, and 8 months (chronic phase) using Vevo 2100 (Fujifilm Inc.) ultrasound system. Left ventricular end-diastolic diameter, Left ventricular end-systolic diameter (LVESD), Left ventricular ejection fraction (LVEF), Global longitudinal (GLS), circumferential (GCS) and radial (GRS) strain were evaluated. Tricuspid annular plane systolic excursion (TAPSE) was used to assess right ventricular function. At 8 months, animals were euthanized and LV myocardial samples were analyzed for quantitation of inflammation and fibrosis. LVEF decreased over time in Chagas group and a difference from Control was detected at 6 months (p-value of groups#time interaction = 0.005). There was a pronounced decrease in GLS, GCS and TAPSE in Chagas group (p-value of groups#time interaction = 0.003 for GLS, < 0.001 for GCS and < 0.009 for TAPSE vs Control) since the first month. LVESD, LVEF and GLS were significantly correlated to the number of inflammatory cells (r = 0.41, p = 0.046; r = − 0.42, p = 0.042; r = 0.41, p = 0.047) but not to fibrosis. In the Syrian hamster model of CD STE parameters (GLS and GCS) showed an early decrease. Changes in LVEF, LVESD, and GLS were correlated to myocardial inflammation but not to fibrosis.

Assessment of left ventricular function and volumes by myocardial perfusion scintigraphy - comparison of two algorithms

2001 ◽  
Vol 40 (05) ◽  
pp. 135-142
Author(s):  
R. Fischer ◽  
B. Saurbier ◽  
I. Brink ◽  
E. Moser ◽  
T. Krause ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Gated Spect ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Practical Application ◽  
Cardiac Volume ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume ◽  
Cardiac Models

Summary Aim: Left ventricular volume and function can be computed from gated SPECT myocardial perfusion imaging using Emory Cardiac Toolbox (ECT) or Gated SPECT Quantification (GS-Quant). The aim of this study was to compare both programs with respect to their practical application, stability and precision on heart-models as well as in clinical use. Methods: The volumes of five cardiac models were calculated by ECT and GS-Quant. 48 patients (13 female, 35 male) underwent a one day stress-rest protocol and gated SPECT. From these 96 gated SPECT images, left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were estimated by ECT and GS-Quant. For 42 patients LVEF was also determined by echocardiography. Results: For the cardiac models the computed volumes showed high correlation with the model-volumes as well as high correlation between ECT and GS-Quant (r ≥ 0.99). Both programs underestimated the volume by approximately 20-30% independent of the ventricle-size. Calculating LVEF, EDV and ESV, GS-Quant and ECT correlated well to each other and to the LVEF estimated by echocardiography (r ≥ 0.86). LVEF values determined with ECT were about 10% higher than values determined with GS-Quant or echocardiography. The incorrect surfaces calculated by the automatic algorithm of GS-Quant for three examinations could not be corrected manually. 34 of the ECT studies were optimized by the operator. Conclusion: GS-Quant and ECT are two reliable programs in estimating LVEF. Both seem to underestimate the cardiac volume. In practical application GS-Quant was faster and easier to use. ECT allows the user to define the contour of the ventricle and thus is less susceptible to artifacts.

scholarly journals Heart transplants for patients with Chagas' heart disease

1995 ◽  
Vol 113 (2) ◽  
pp. 873-879 ◽  
Author(s):  
Edimar Alcides Bocchi
Keyword(s):  
Heart Disease ◽  
Chagas Disease ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Heart Transplants ◽  
Ventricular Ejection Fraction ◽  
Chagas Heart Disease ◽  
The Mean ◽  
Cruzi Infection

The role of heart transplants for treating Chagas' heart disease is not quite clear. Immunosuppression could lead to resurgence of T. cruzi infection with acute or chronic damage to the allograft. There are few publications regarding this issue. Thus we reported the follow-up of 18-patients with Chagas' heart disease submitted to orthotopic heart transplants from 1985 to 1993 at The Heart Institute. The patients were in functional class IV or III, or II, with sustained ventricular tachycardia episodes. The mean left ventricular ejection fraction was 25 ± 9% and the mean right ventricular ejection was 22 ± 6% (MUGA). Immunosuppression was based on cyclosporin, azathioprine and corticosteroids. For specific post-transplant monitoring of T. cruzi infection, blood tests were performed (examination of blood or leukocyte concentrate, Giemsa-stained blood smears, blood culture, xenodiagnosis, mouse inoculation) and tissue biopsy (skin or myocardium). In addition, complement fixation hemagglutination and immunofluorescence assays were performed. T. cruzi parasitemias were detected in 18 circumstances in 13 patients. Resurgence of Chagas' disease was diagnosed in 11 circumstances in 5 patients. Fever, subcutaneous nodules and myocarditis predominated in these episodes. All episodes of parasitemia and Chagas' disease resurgence were successfully treated with benzonidazole. All surviving patients had normal cardiac function despite left ventricular function worsening during some myocarditis episodes. Neoplasias were important findings and 3 patients developed lymphoproliferative disease, 2 developed Karposi's sarcoma and 1 patient developed skin cancer. The survival rates at 4 and 12 months were 83% and 49% respectively. The survival of patients who underwent heart transplants from August 1991 to April 1993 was 100% at 4 months and 75% at 12 months. Heart transplants for Chagas' heart disease may be associated with episodes of parasitemia and a reoccurrence of episodes of Chaga's disease. The survival of heart transplanted patients has improved when associated with lower doses of cyclosporins and thus, fewer resurgences of the disease.

Abstract 248: Prospective Study of Ventricular Function and Survival in Acute Phase of Chagas Disease: An Animal Experimental Model

2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Arthur L Vargas ◽  
Beatriz P Dias ◽  
Henrique T Moreira ◽  
Denise M Tanaka ◽  
Edgard C Oliveira Filho ◽  
...  
Keyword(s):  
Ventricular Function ◽  
Experimental Model ◽  
Chagas Disease ◽  
Acute Phase ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Vector Transmission ◽  
Ventricular Ejection Fraction ◽  
Over Time ◽  
Animal Experimental Model

Background: Acute Cardiomyopathy secondary to Chagas disease is often subclinical when related to vector transmission. However, cases related to non-vector transmission as in patients submitted to cardiac transplant may have fatal outcomes. This study aimed to assess survival during the acute phase of Chagas disease and its relation to the ventricular function in an animal experimental model. Methods: Female Syrian hamsters (n=45) were separated in two groups: control group (CG):15 animals injected with saline solution; and infected group (IG): 30 animals inoculated with 3,5x10 4 trypomastigote forms of Trypanosoma cruzi,Y strain . Both groups were monitored daily and submitted to echocardiography with equipment dedicated to small animals (Vevo® 2100) in two different moments: baseline (before infection) and 15 days post infection. Left ventricular ejection fraction (LVEF) and global longitudinal myocardial strain (GLS) of left ventricle were measured. The IG was divided into animals with and without clinical sign (CS+) of disease: weight or fur loss, mucous wounds and lethargy. ANOVA for mixed models was used to compare the ventricular function parameters among groups over time. Survival analysis was studied using Kaplan-Meier curves and logrank test. Results: Total time follow up was 60 days. LVEF in IG was significantly reduced through time (53.80 ± 4.95 to 43.55 ± 12.10%) compared to CG (57.86 ± 7.52 to 59.73 ± 5.87%) (p=0.002). There was also a significant reduction of GLS (-18.97 ± 3.94 to -12.44 ± 4.79%) in the IG compared to CG (-19.58 ± 4.03 to -19.67 ± 4.04%) (p=0.012). Twelve animals from IG died (40.00%,12 out of 30) compared to one from CG (6.66%, 1 out of 15). Eleven out of the 12 dead animals from IG, presented, before, clinical signs (CS+). Survival was significant reduced in the IG compared to CG over time (p=0.02) (Figure 1). Conclusion: Reduced survival during the acute phase of experimental model of Chagas disease is related to the significant reduction of left ventricular function. The mortality rate in the IG is higher in the group which presents CS+.

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