Radionuclide Imaging in Chagas Cardiomyopathy
Purpose of Review
To review the contributions of radionuclide imaging to understanding the manifestations and pathophysiology of chronic Chagas cardiomyopathy (CCC).
Experimental studies using high-resolution SPECT myocardial perfusion imaging (MPI) show that myocardial perfusion derangement that corresponds to dysfunctional, viable myocardium is closely linked to inflammation and precedes LV regional systolic dysfunction. Clinical studies show that microvascular ischemia is strictly related to the areas of cardiac sympathetic denervation, assessed by 123I-MIBG imaging, which correlates with severe ventricular arrhythmia incidence. Initial case reports suggest that 18F-FDG-PET imaging is a promising, non-invasive detection method for myocardial inflammation.
Available evidence indicates that microvascular ischemia participates in the mechanisms causing myocardial injury in CCC, with potential implication for monitoring subclinical disease progression. Moreover, MIBG imaging is a promising tool for risk stratification of sudden death. Preliminary clinical experience suggests a role for 18F-FDG-PET in detection of inflammation in CCC.
KeywordsChagas disease Cardiomyopathy Radionuclide imaging Scintigraphy Myocardial perfusion Myocarditis
Compliance with Ethical Standards
Conflict of Interest
Marcus Vinicius Simões, Leonardo Pippa Gadioli, and Luciano Fonseca Lemos de Oliveira declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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