Left Atrial Function in Patients with Chronic Chagasic Cardiomyopathy

Claudia da Silva Fragata, Afonso Y. Matsumoto, Felix J. A. Ramires, Fabio Fernandes, Paula de Cássia Buck, Vera Maria C. Salemi, Luciano Nastari, Charles Mady, Barbara Maria Ianni

Chagas disease is a cause of dilated cardiomyopathy, and information about left atrial (LA) function in this disease still lacks. To assess the different LA functions (reservoir, conduit and pump functions) and their correlation with the echocardiographic parameters of left ventricular (LV) systolic and diastolic functions. 10 control subjects (CG), and patients with Chagas disease as follows: 26 with the indeterminate form (GI); 30 with ECG alterations (GII); and 19 with LV dysfunction (GIII). All patients underwent M-mode and two-dimensional echocardiography, pulsed-wave Doppler and tissue Doppler imaging. Reservoir function (Total Emptying Fraction: TEF): (p <0.0001), lower in GIII as compared to CG (p = 0.003), GI (p <0.001) and GII (p <0.001). Conduit function (Passive Emptying Fraction: PEF): (p = 0.004), lower in GIII (GIII and CG, p = 0.06; GI and GII, p = 0.06; and GII and GIII, p = 0.07). Pump function (Active Emptying Fraction: AEF): (p = 0.0001), lower in GIII as compared to CG (p = 0.05), GI (p<0.0001) and GII (p = 0.002). There was a negative correlation of E/e' average with the reservoir and pump functions (TEF and AEF), and a positive correlation of e' average with s' wave (both septal and lateral walls) and the reservoir, conduit and pump LA functions. An impairment of LA functions in Chagas cardiomyopathy was observed.