Why the study?
Current guidelines lack clear recommendations for early cardioverter-defibrillator implantation in Chagas heart disease, creating a need to evaluate sudden cardiac death risk earlier using new imaging methods.
Advanced imaging modalities may help identify early myocardial changes in Chagas disease to better stratify the risk of sudden cardiac death and guide primary preventive strategies.
May refine SCD risk stratification without altering ICD thresholds yet; leaves open outcome trials of imaging-guided primary prevention.
Chronic Chagas' cardiomyopathy is the most severe and frequent manifestation of Chagas disease, and has a high social and economic burden. New imaging modalities, such as strain echocardiography, nuclear medicine, computed tomography and cardiac magnetic resonance imaging, may detect the presence of myocardial fibrosis, inflammation or sympathetic denervation, three conditions associated with risk of sudden death, providing additional diagnostic and/or prognostic information. Unfortunately, despite its high mortality, there is no clear recommendation for early cardioverter-defibrillator implantation in patients with Chagas heart disease in the current guidelines. Ideally, the risk of sudden cardiac death may be evaluated in earlier stages of the disease using new image methods to allow the implementation of primary preventive strategies.
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Moll‐Bernardes et al. (2020) studied this question.
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