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Chagas’ heart disease is an important public health problem in South America.Several aspects of the pathogenesis are not fully understood, especially in its subclinical phases.On pathology Chagas’ heart disease is characterized by chronic myocardial inflammation and extensive myocardial fibrosis.The latter has also been demonstrated by late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR).In three clinical phases of this disease, we sought to investigate the presence of LGE, myocardial increase in signal intensity in T2-weighted images (T2W) and in T1-weighted myocardial early gadolinium enhancement (MEGE), previously described CMR surrogates for myocardial fibrosis, myocardial edema and hyperemia, respectively. Sixteen patients with the indeterminate phase (IND), seventeen patients with the cardiac phase with no left ventricular systolic dysfunction (CPND), and twenty-one patients with the cardiac phase with left ventricular systolic dysfunction (CPD).All patients underwent 1.5 T CMR scan including LGE, T2W and MEGE image sequences to evaluate myocardial abnormalities.Increase in T2-weighted (T2W) myocardial signal intensity and T1-weighted myocardial early gadolinium enhancement (MEGE) can be detected by CMR in patients throughout all phases of Chagas’ heart disease, including its subclinical presentation (IND).
] and it is still a public health problem in South America with an estimated of 13 % of Latin American population at risk of contracting this disease.
With an annual incidence of 29,925 cases in 21 Latin American countries, this disease still affects approximately 5.7 million people .
Chagas’ disease has a disease burden, measured by disability-adjusted life years that is 7.5 times higher than malaria, which makes it the parasitic disease with the highest disease burden in the Western Hemisphere .
Chagas’ heart disease is the most serious complication of CD, striking approximately one-third of seropositive individuals and the leading cause of death from heart failure in Latin America.
The asymptomatic phase can last for decades, corresponding to the clinical indeterminate phase (IND), until unknown triggers initiate the progression to arrhythmias and heart failure in a subset, which represents approximately one third of the patients.