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Chagas’ Disease: Update on Current Diagnosis

  • Metabolic Syndrome and Diabetes (V Dilsizian and T Schindler, Section Editors)
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Abstract

Purpose of Review

Chagas’ disease has become an emerging health problem due to increased migration. In the present review, we have summarized the usefulness of non-invasive imaging tools for the diagnosis of cardiac involvement in Chagas’ disease, with emphasis on modern technologies. M-mode, bidimensional (2-D), and three-dimensional (3-D) echocardiographies may allow the evaluation of left ventricular (LV) regional and global contractile function, right ventricle (RV) impairment, evidence of aneurysms and thrombi, and assessment of diastolic function in any stage of the disease.

Recent Findings

New modalities such as strain and speckle-tracking imaging have brought non-invasive indices to the understanding of the mechanisms of cardiac dyssynchrony. The assessment of cardiac autonomic denervation using 123I-metaiodobenzylguanidine (123I-MIBG), LV, and RV systolic function and the study of LV mechanical dyssynchrony by gated cardiac blood pool are available in current nuclear imaging for patients with Chagas’ disease. The findings of myocardial fibrosis by cardiac magnetic resonance (CMR), mainly in inferolateral regions, are a marker of subclinical involvement and worse prognosis in Chagas’ disease, even in patients with preserved ventricular function.

Summary

The detection and quantification of early signs of heart involvement by new technologies should be useful for risk stratification and in the clinical decision process for new therapeutic methods and could improve the natural history of the disease.

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Authors and Affiliations

  1. Nuclear Medicine and Molecular Imaging Department - Heart Institute (InCor), São Paulo University Medical School, São Paulo, Brazil

    Andréa Marinho Falcão, Maria Clementina Giorgi & William A. Chalela

  2. Echocardiography Department - Heart Institute (InCor), São Paulo University Medical School, São Paulo, Brazil

    Marcelo L. Campos Vieira

  3. Duke Department of Radiology and Division of Nuclear Medicine, Durham, NC, USA

    Salvador Borges-Neto

Authors
  1. Andréa Marinho Falcão
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  2. Maria Clementina Giorgi
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  3. Marcelo L. Campos Vieira
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  4. William A. Chalela
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  5. Salvador Borges-Neto
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Correspondence to Andréa Marinho Falcão.

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Andréa M. Falcão, Maria Clementina Giorgi, Marcelo L. Campos Vieira, William A. Chalela, and Salvador Borges-Neto declare that they have no conflict of interest.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and were in compliance with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Metabolic Syndrome and Diabetes

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Falcão, A.M., Giorgi, M.C., Vieira, M.L.C. et al. Chagas’ Disease: Update on Current Diagnosis. Curr Cardiovasc Imaging Rep 9, 33 (2016). https://doi.org/10.1007/s12410-016-9394-9

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