Post-extrasystolic potentiation in chronic Chagas' heart disease. A radiologic contrast ventriculography study

To determine the existence and frequency of the phenomenon of post-extrasystolic potentiation in dyssynergic myocardial areas of patients with chronic Chagas' heart disease studied by use of radiologic contrast ventriculography. This study is a semiquantitative retrospective analysis of radiolo...

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Published in:Arquivos brasileiros de cardiologia 2005-05, Vol.84 (5), p.376-380
Main Authors: Brandão, José Mário M, Miziara, Andrea, Figueiredo, Geraldo Luiz de, Lima-Filho, Moysés O, Ayres-Neto, Elias M, Marin-Neto, José Antonio
Format: Article
Language:Portuguese
Subjects:
Chagas Disease - diagnostic imaging
Chagas Disease - physiopathology
Chronic Disease
Contrast Media
Heart Rate
Humans
Myocardial Contraction - physiology
Radionuclide Ventriculography
Retrospective Studies
Statistics, Nonparametric
Ventricular Premature Complexes - diagnostic imaging
Ventricular Premature Complexes - physiopathology
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Summary:To determine the existence and frequency of the phenomenon of post-extrasystolic potentiation in dyssynergic myocardial areas of patients with chronic Chagas' heart disease studied by use of radiologic contrast ventriculography. This study is a semiquantitative retrospective analysis of radiologic contrast ventriculography in patients with chronic Chagas' disease, who were consecutively studied to assess the mechanisms of ventricular tachycardia. Of the 72 patients initially included, in only 20 patients was possible the ventriculographic analysis for the purposes of this study. The phenomenon of post-extrasystolic potentiation was observed in 11 (55%) of these patients, and a 15.31% improvement was observed in the contractility score from the baseline to the post-extrasystole condition (P=0.0001). That phenomenon occurred even in ventricular segments with an intense deficit in contractility. The phenomenon of post-extrasystolic potentiation is observed in a significant proportion of patients with chronic Chagas' heart disease, in whom the phenomenon could be angiographically analyzed, indicating the existence of potentially recruitable contractile reserve in ventricular regions, showing marked dyssynergy. Additional studies for clarifying the underlying mechanisms are required.
ISSN:0066-782X