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Early Right Cardiac Dysfunction in Patients with Schistosomiasis Mansoni
Author(s) -
Carvalho Vinicius T.,
Barbosa Marcia M.,
Nunes Maria Carmo P.,
Cardoso Yuri S.,
de Sá Filho Isaías M.,
Oliveira Flávia R.,
Antunes Carlos Maurício F.,
Lambertucci José R.
Publication year - 2011
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2010.01330.x
Subject(s) - medicine , regurgitation (circulation) , cardiology , pulmonary artery , pulmonary hypertension , complication , diastole , cardiac index , doppler echocardiography , right heart , schistosomiasis , blood pressure , cardiac output , immunology , helminths
Background: Pulmonary hypertension (PH) is a complication of schistosomiasis mansoni (SM), mainly in the hepatosplenic form. However, its prevalence is not well established. We evaluated the usefulness of Doppler echocardiographic indexes to detect right heart dysfunction in SM. Methods: A total of 83 patients divided into two groups were studied: Group 1: 44 patients with hepatosplenic SM, and Group 2: 39 patients with hepatointestinal SM who served as controls. All patients underwent a Doppler echocardiogram. Right ventricular end‐diastolic area (RVEDA), the peak systolic tricuspid annular tissue velocity (S’), right ventricular index of myocardial performance (RVIMP) and right atrial area (RAA) were measured in all patients. Tricuspid regurgitation peak velocity (TR) was measured and the pressure gradient (TG) was obtained. Results: The prevalence of patients with elevated systolic pulmonary artery pressure at echocardiography was 31% in hepatosplenic patients, while no patient with the hepatointestinal form presented PH. Patients with hepatosplenic SM had larger RVEDA (10.0 ± 2.8 vs. 8.5 ± 1.8 cm 2 /m, P = 0.006) and RAA (9.39 [8.3–11.0] vs. 7.7 [6.9–8.4 cm 2 /m], P < 0.001). There was correlation between TG and RVIMP (r = 0.58; P < 0.001) and between TG and RAA (r = 0.36; P = 0.03) in Group 1. Conclusion: Larger RAA and RVEDA were found in patients with hepatosplenic SM, when compared to patients with the hepatointestinal form, which may suggest early impairment of RV function in patients with hepatosplenic SM. (Echocardiography 2011;28:261‐267)