Left Ventricular Function and Myocardial Longitudinal Strain Analysis in Patients With Chagas Disease: Case Series and Systematic Literature Review

Introduction: Left ventricular dysfunction as an independent predictor of mortality in Chagas disease.Global longitudinal strain (GLS) is an emerging echocardiographic modality with possible incremental value in early detection of cardiac involvement.Objective: Compare left ventricular function with multiple echocardiographic parameters between patients with the indeterminate and chronic forms of Chagas, and perform a literature review.Methods: In this observational study, 11 patients with a confirmed diagnosis of Chagas disease were evaluated.Individuals were distributed as follows: five with the indeterminate and six with the chronic forms.Conventional echocardiographic evaluation was followed by GLS measurement.Results: The mean left ventricle ejection fraction left ventricular ejection fraction (LVEF) was 33 ± 2.88, and the mean GLS of the left ventricle was -10.76 ± 2.20 in the chronic form as compared to 57.80 ± 6.49 and -17.34 ± 3.82, respectively in the indeterminate group.Contractility was reduced in segments of the inferior, inferoseptal and anteroseptal walls in both groups.These segmental alterations in the indeterminate group may be attributed to early myocardial damage from inflammation and fibrosis, even before significant left ventricular dysfunction is evident.Conclusion: Analysis of longitudinal strain in the indeterminate form has potential incremental value to the conventional analysis of ejection fraction when compared to patients with chronic Chagas cardiomyopathy, especially with individual segmental analysis, but the impact and clinical significance of these techniques are still unknown.