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The severity of ventricular arrhythmia correlates with the extent of myocardial sympathetic denervation, but not with myocardial fibrosis extent in chronic Chagas cardiomyopathy : Chagas disease, denervation and arrhythmia.
Gadioli, Leonardo Pippa; Miranda, Carlos Henrique; Pintya, Antonio Osvaldo; de Figueiredo, Alexandre Baldini; Schmidt, André; Maciel, Benedito Carlos; Marin-Neto, José Antonio; Simões, Marcus Vinicius.
Afiliação
  • Gadioli LP; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
  • Miranda CH; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
  • Pintya AO; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
  • de Figueiredo AB; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
  • Schmidt A; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
  • Maciel BC; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
  • Marin-Neto JA; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
  • Simões MV; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. msimoes@fmrp.usp.br.
J Nucl Cardiol ; 25(1): 75-83, 2018 02.
Article em En | MEDLINE | ID: mdl-27381340
BACKGROUND: To investigate the correlation between the extent of myocardial sympathetic denervation and fibrosis and the presence of degrees of severity of ventricular arrhythmias in chronic Chagas cardiomyopathy (CCC). METHODS: Forty-three CCC patients with left ventricular ejection fraction (LVEF) ≥ 35% were divided into three groups: SVT group-presenting Sustained Ventricular Tachycardia (SVT) (n = 15), NSVT group-exhibiting episodes of non-SVT (NSVT) on 24-h Holter monitoring (n = 11), and Control group-exhibiting neither SVT nor episodes of NSVT (n = 17). The patients underwent SPECT imaging for myocardial sympathetic innervation with 123Iodine-MIBG (MIBG) and myocardial perfusion with 99mTc-Sestamibi (MIBI) for the evaluation of regional myocardial fibrosis. RESULTS: The summed rest perfusion scores were similar in the three groups. The summed difference score between MIBG and MPI images, which evaluated the extent of denervated but viable myocardium, was significantly higher in SVT group (20.0 ± 8.0) as compared with the control group (2.0 ± 5.0, P < .0001) and with the NSVT group (11.0 ± 8.0, P < .05). CONCLUSIONS: The occurrence of ventricular arrhythmias of different degrees of severity correlates quantitatively with the extent of cardiac sympathetic denervation, but not with the extent of fibrosis, suggesting that myocardial sympathetic denervation plays a major role in triggering ventricular arrhythmia in CCC.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Arritmias Cardíacas / Simpatectomia / Tomografia Computadorizada de Emissão de Fóton Único / Cardiomiopatia Chagásica / Imagem de Perfusão do Miocárdio Tipo de estudo: Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Nucl Cardiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Arritmias Cardíacas / Simpatectomia / Tomografia Computadorizada de Emissão de Fóton Único / Cardiomiopatia Chagásica / Imagem de Perfusão do Miocárdio Tipo de estudo: Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Nucl Cardiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos