CARDIAC MAGNETIC RESONANCE IN THE EVALUATION OF FIBROSIS IN CHAGAS’ DISEASE

Abstract

Introduction: Chagas’ disease (CD) is the leading cause of heart failure in endemic regions. Although its pathogenesis is not clearly defined, the cardiac form is characterized by chronic inflammation and myocardial fibrosis (MF). The Cardiac Magnetic Resonance (CMR) is the gold standard noninvasive method for analysis of MF through the myocardial delayed enhancement technique (MDE). Objective: To evaluate the use of CMR in patients with CD, with emphasis on evaluation of myocardial fibrosis and inflammation. Method: Study of literature review, developed from the electronic PUBMED database using the descriptors: “cardiac magnetic resonance”, “chagas disease” from January 1993 to June 2014. Results: Of the 62 articles found, 10 were selected. Three of these studies compared CMR with endomyocardial biopsy and failed to demonstrate a high sensitivity of CMR for detecting MF. Recently, some authors have been investigating MF and cardiac inflammation with CMR in Chagas’ disease, and were able to establish the CMR as an important tool for prognostic stratification of patients with chronic chagasic cardiomyopathy (CCC). Conclusions: CMR is an important diagnostic tool in cardiac involvement in CD, allowing more precise stratification of its severity stages.