Detection of early right ventricular dysfunction in Chagas' disease using Doppler tissue imaging

Background: The involvement of the right ventricle (RV) in Chagas' disease is frequent. Although echocardiography plays an important role in noninvasive assessment of cardiac function, evaluation of RV is challenging because of the anatomic and functional complexity of this chamber. Methods: To study early functional abnormalities in the RV, we selected 18 patients with Chagas' disease, no other disease, and a normal echocardiogram; and 12 normal individuals as a control group. All participants were submitted to Doppler tissue imaging and the parameters of systolic (systolic wave and regional isovolumic contraction time) and diastolic (early and late expansion waves) function were analyzed at the level of the interventricular septum and free wall of the RV. Results: Regional isovolumic contraction time values showed a statistically significant difference between the 2 groups both in the RV free (P = .0003) and septal (P = .003) walls. With respect to diastolic function, we observed a significant difference between groups involving the early expansion wave (P = .014) and e/a ratio (P = .004) of the RV free wall. Conclusion: Doppler tissue imaging proved to be useful in early detection of RV dysfunction in Chagas' disease, with potential use in risk stratification of these patients.