Autonomic denervation, myocardial hypoperfusion and fibrosis may predict ventricular arrhythmia in the early stages of Chagas cardiomyopathy

Adriana Soares Xavier de Brito; Renata Junqueira Moll-Bernardes; Martha Valéria Tavares Pinheiro; Gabriel Cordeiro Camargo; Fabio Paiva Rossini Siqueira; Renee Sarmento Oliveira; Adriana Pereira Glavam; Sergio Altino de Almeida; Marcelo Teixeira de Holanda; Luiz Henrique Conde Sangenis; Fernanda de Souza Nogueira Sardinha Mendes; Paulo Henrique Rosado-de-Castro; Andrea Silvestre de Sousa

doi:10.1007/s12350-023-03281-9

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Autonomic denervation, myocardial hypoperfusion and fibrosis may predict ventricular arrhythmia in the early stages of Chagas cardiomyopathy

Journal article

Peer reviewed

Autonomic denervation, myocardial hypoperfusion and fibrosis may predict ventricular arrhythmia in the early stages of Chagas cardiomyopathy

Adriana Soares Xavier de Brito, Renata Junqueira Moll-Bernardes, Martha Valéria Tavares Pinheiro, Gabriel Cordeiro Camargo, Fabio Paiva Rossini Siqueira, Renee Sarmento Oliveira, Adriana Pereira Glavam, Sergio Altino de Almeida, Marcelo Teixeira de Holanda, Luiz Henrique Conde Sangenis, …

Journal of nuclear cardiology, Vol.30(6), pp.2379-2388

12/01/2023

DOI: 10.1007/s12350-023-03281-9

PMID: 37226005

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Abstract

Sudden cardiac death (SCD) can be the first clinical event of Chagas heart disease (CHD). However, current guidelines contain no clear recommendation for early cardioverter-defibrillator implantation. Using imaging modalities, we evaluated associations among autonomic denervation, myocardial hypoperfusion, fibrosis and ventricular arrhythmia in CHD. Twenty-nine patients with CHD and preserved left ventricular function underwent 123I-metaiodobenzylguanidine (MIBG) scintigraphy, 99mTc-methoxyisobutylisonitrile (MIBI) myocardial perfusion and cardiac magnetic resonance imaging (MRI). They were divided into arrhythmic (≥ 6 ventricular premature complexes/h and/or non-sustained ventricular tachycardia on 24-hour Holter, n = 15) and non-arrhythmic (< 6 ventricular premature complexes/h and no ventricular tachycardia; n = 14) groups. The arrhythmic group had higher denervation scores from MIBG imaging (23.2 ± 18.7 vs 5.6 ± 4.9; P < .01), hypoperfusion scores from MIBI SPECT (4.7 ± 6.8 vs 0.29 ± 0.6: P = .02), innervation/perfusion mismatch scores (18.5 ± 17.5 vs 5.4 ± 4.8; P = .01) and fibrosis by late gadolinium enhancement on MRI (14.3% ± 13.5% vs 4.0% ± 2.9%; P = .04) than the non-arrhythmic group. These imaging parameters were associated with ventricular arrhythmia in early CHD and may enable risk stratification and the implementation of primary preventive strategies for SCD.

autonomic denervation

Chagas disease

myocardial fibrosis

myocardial hypoperfusion

ventricular arrhythmia

Details

Title: Subtitle: Autonomic denervation, myocardial hypoperfusion and fibrosis may predict ventricular arrhythmia in the early stages of Chagas cardiomyopathy
Creators: Adriana Soares Xavier de Brito - D’Or Institute for Research and Education
Renata Junqueira Moll-Bernardes - D’Or Institute for Research and Education
Martha Valéria Tavares Pinheiro - D’Or Institute for Research and Education
Gabriel Cordeiro Camargo - D’Or Institute for Research and Education
Fabio Paiva Rossini Siqueira - D’Or Institute for Research and Education
Renee Sarmento Oliveira - D’Or Institute for Research and Education
Adriana Pereira Glavam - D’Or Institute for Research and Education
Sergio Altino de Almeida - D’Or Institute for Research and Education
Marcelo Teixeira de Holanda - Fundação Oswaldo Cruz
Luiz Henrique Conde Sangenis - Fundação Oswaldo Cruz
Fernanda de Souza Nogueira Sardinha Mendes - National Institute of Infectious Diseases
Paulo Henrique Rosado-de-Castro - D’Or Institute for Research and Education
Andrea Silvestre de Sousa - Fundação Oswaldo Cruz
Resource Type: Journal article
Publication Details: Journal of nuclear cardiology, Vol.30(6), pp.2379-2388
DOI: 10.1007/s12350-023-03281-9
PMID: 37226005
NLM abbreviation: J Nucl Cardiol
ISSN: 1071-3581
eISSN: 1532-6551
Publisher: Elsevier Inc
Number of pages: 10
Language: English
Date published: 12/01/2023
Academic Unit: Radiology
Record Identifier: 9985143550602771

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