Right ventricular dysfunction in Chagas' Cardiomyopathy. Primary involvement or a resonant manifestation of Left ventricular dysfunction?

Background Chagas’ Cardiomyopathy (CC) is an important cause of heart failure and sudden cardiac death (SCD) in Latin America. Migratory movements have spread carriers throughout the world, especially in USA and Europe. Left Ventricle (LV) involvement is a landmark and apical aneurysm a pathognomical sign. Nevertheless, early involvement of the right ventricle (RV) and RV systolic dysfunction in presence of normal left ventricular systolic function in CC has been a subject of controversy in the literature. Therefore, we analyzed a cohort of patients with CC in order to explore the presence of RV dysfunction. Methods 125 patients with CC were submitted to cardiac magnetic resonance during an investigational protocol for primary prevention of SCD. SSFP short-axis cines were used to establish RV and LV volumes, mass and function. Late Gadolinium Enhanced (LGE) short axis sequences were visually analyzed to establish the presence of a LV scar. RV and LV systolic dysfunction were established using most recent recommendations of the European Society of Cardiology. Parametric tests and Chi-square tests were used as appropriate and P < 0.05 was established as significant.