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Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2017

Open Access 01-01-2017 | Research

Chagas’ heart disease: gender differences in myocardial damage assessed by cardiovascular magnetic resonance

Authors: Antonildes N. Assunção Jr, Michael Jerosch-Herold, Rodrigo L. Melo, Alejandra V. Mauricio, Liliane Rocha, Jorge A. Torreão, Fabio Fernandes, Barbara M. Ianni, Charles Mady, José A. F. Ramires, Roberto Kalil-Filho, Carlos E. Rochitte

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2017

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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 (P for mediation = 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.

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Metadata
Title
Chagas’ heart disease: gender differences in myocardial damage assessed by cardiovascular magnetic resonance
Authors
Antonildes N. Assunção Jr
Michael Jerosch-Herold
Rodrigo L. Melo
Alejandra V. Mauricio
Liliane Rocha
Jorge A. Torreão
Fabio Fernandes
Barbara M. Ianni
Charles Mady
José A. F. Ramires
Roberto Kalil-Filho
Carlos E. Rochitte
Publication date
01-01-2017
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2017
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/s12968-016-0307-5

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