Assessment of speckle tracking strain predictive value for myocardial fibrosis in subjects with Chagas disease

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-05-12T12:36:51Z No. of bitstreams: 1 Macedo CT Assessment....pdf: 661652 bytes, checksum: a14aaf455b6a4c89eef253f8b95079bc (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-05-12T12:51:06Z (GMT) No. of bitstreams: 1 Macedo CT Assessment....pdf: 661652 bytes, checksum: a14aaf455b6a4c89eef253f8b95079bc (MD5)Made available in DSpace on 2016-05-12T12:51:06Z (GMT). No. of bitstreams: 1 Macedo CT Assessment....pdf: 661652 bytes, checksum: a14aaf455b6a4c89eef253f8b95079bc (MD5) Previous issue date: 2015Hospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilBackground: One of the most challenging issues of chronic Chagas disease is to provide earlier detection of heart involvement. Two-dimensional speckle tracking (2-D ST) echocardiography, a new imagingmodalitywith useful applications in several cardiac diseases, has been validated for subjects with myocardial infarction against cardiac magnetic resonance (CMR). Here we hypothesize that the longitudinal global strain (LGS) has an incremental value to ejection fraction for predicting myocardial fibrosis in subjects with Chagas disease. Methods: This observational study comprised 58 subjectswith Chagas disease, confirmed by two positive serologic tests. All subjects underwent conventional Doppler echocardiogramplus speckle tracking strain, and cardiacmagnetic resonance. Results: The ROC curve analysis revealed that both LGS (area under the curve: 0.78, p=0.001) and ejection fraction (area under the curve: 0.82, p b 0.001)were significant predictors ofmyocardial fibrosis. Regarding the percentage of fibrosis, a high correlation was observed with both ejection fraction assessed by echocardiography (r =0.70, p b 0.001) and LGS (r = 0.64, p b 0.001). However, when adjusted through multiple linear regression, the LGS lost statistical significance as a predictor of myocardial fibrosis (p = 0.111). Conclusions: LGS has no incremental value to conventional ejection fractionmeasurement in the prediction ofmyocardial fibrosis in subjects with Chagas disease