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- Title
Chagas' heart disease: gender differences in myocardial damage assessed by cardiovascular magnetic resonance.
- Authors
Assunção Jr, Antonildes N.; Jerosch-Herold, Michael; Melo, Rodrigo L.; Mauricio, Alejandra V.; Rocha, Liliane; Torreão, Jorge A.; Fernandes, Fabio; Ianni, Barbara M.; Mady, Charles; Ramires, José A. F.; Kalil-Filho, Roberto; Rochitte, Carlos E.
- Abstract
Background: Since a male-related higher cardiovascular morbidity and mortality in patients with Chagas' heart disease has been reported, we aimed to investigate gender differences in myocardial damage assessed by cardiovascular magnetic resonance (CMR). Methods and results: Retrospectively, 62 seropositive Chagas' heart disease patients referred to CMR (1.5 T) and with low probability of having significant coronary artery disease were included in this analysis. Amongst both sexes, there was a strong negative correlation between LV ejection fraction and myocardial fibrosis (male r = 0.64, female r = 0.73, both P < 0.001), with males showing significantly greater myocardial fibrosis (P = 0.002) and lower LV ejection fraction (P < 0.001) than females. After adjustment for potential confounders, gender remained associated with myocardial dysfunction, and 53% of the effect was mediated by myocardial fibrosis (for mediation P = 0.004). Also, the transmural pattern was more prevalent among male patients (23.7 vs. 9.9%, P < 0.001) as well as the myocardial heterogeneity or gray zone (2.2 vs. 1.3 g, P = 0.003). Conclusions: We observed gender-related differences in myocardial damage assessed by CMR in patients with Chagas' heart disease. As myocardial fibrosis and myocardial dysfunction are associated to cardiovascular outcomes, our findings might help to understand the poorer prognosis observed in males in Chagas' disease.
- Subjects
BRAZIL; CARDIOVASCULAR diseases; CHI-squared test; CONFIDENCE intervals; FISHER exact test; MAGNETIC resonance imaging; RESEARCH funding; SEX distribution; STATISTICAL hypothesis testing; TRYPANOSOMIASIS; VENTRICULAR remodeling; CROSS-sectional method; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; CORONARY angiography; MANN Whitney U Test
- Publication
Journal of Cardiovascular Magnetic Resonance (BioMed Central), 2016, p1
- ISSN
1532-429X
- Publication type
Article
- DOI
10.1186/s12968-016-0307-5