Document Detail


Peculiar aspects of cardiogenic embolism in patients with Chagas' cardiomyopathy: a transthoracic and transesophageal echocardiographic study.
MedLine Citation:
PMID:  16003275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to detect cardiac thrombi by transthoracic and transesophageal echocardiography in patients with Chagas' cardiomyopathy and to determine the relationship of these thrombi with left ventricular systolic function and with the presence of stroke. BACKGROUND: Thromboembolic events are a serious complication of Chagas' cardiomyopathy. Because most data come from autopsy studies, the prevalence of cardiac thrombi for patients who are clinically stable is unknown. METHODS: A total of 75 patients (52 men; mean age 48 +/- 13 years) with Chagas' cardiomyopathy were prospectively studied by transthoracic and transesophageal echocardiography and followed for 24 +/- 10 months. RESULTS: In all, 14 patients (19%) had a history of stroke at the time of enrollment and two had this complication at follow-up. Most patients (88%) were in New York Heart Association (NYHA) functional classes I and II and 9 (12%) were in classes III and IV. Mean ejection fraction was 40 +/- 13%. A total of 17 patients (23%) had left ventricular thrombus on transthoracic echocardiography and this finding was associated with a history of stroke ( P = .01). Apical aneurysm occurred in 35 patients (47%) and it was associated both with thrombus and stroke ( P = .04). Strokes were more frequent ( P = .04) among patients with mild systolic dysfunction (57% of patients with strokes were in NYHA I). Four patients (5%) had thrombi at the left atrial appendage, and one (1%) at the right atrial appendage. A total of 13 patients (17%) died at follow-up. CONCLUSIONS: Stroke was frequent in Chagas' cardiomyopathy and associated with mild systolic dysfunction and with intracardiac thrombi. These occurred mainly in the typical apical aneurysm of Chagas' disease.
Authors:
Maria do Carmo P Nunes; Márcia M Barbosa; Manoel Otávio C Rocha
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  18     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-08     Completed Date:  2006-04-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  761-7     Citation Subset:  IM    
Affiliation:
Postgraduate Course of Tropical Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. mcarmo@waymail.com.br
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MeSH Terms
Descriptor/Qualifier:
Brazil / epidemiology
Chagas Cardiomyopathy / epidemiology*,  ultrasonography*
Comorbidity
Echocardiography / statistics & numerical data
Echocardiography, Transesophageal / statistics & numerical data
Female
Humans
Incidence
Intracranial Embolism / epidemiology*,  ultrasonography
Male
Middle Aged
Risk Assessment / methods
Risk Factors
Stroke / diagnosis,  epidemiology*
Thrombosis / diagnosis,  epidemiology*
Ventricular Dysfunction, Left / diagnosis,  epidemiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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