Chronic Chagas Cardiomyopathy in the Brazilian Amazon region: clinical characteristics and regional distinctiveness

Elsa Isela Guevara Moctezuma; Susan Smith Doria; Jessica Vanina Ortiz; Débora Raysa Teixeira de Sousa; Victor Irungu Mwangi; Katia do Nascimento Couceiro; Alba Regina Jorge Brandão; Jorge Augusto de Oliveira Guerra; Maria das Graças Vale Barbosa Guerra; João Marcos Barbosa Bemfica Ferreira

doi:10.3389/fpubh.2023.1284639

Chronic Chagas Cardiomyopathy in the Brazilian Amazon region: clinical characteristics and regional distinctiveness

Front Public Health. 2023 Nov 27:11:1284639. doi: 10.3389/fpubh.2023.1284639. eCollection 2023.

Authors

Elsa Isela Guevara Moctezuma^{1

2}, Susan Smith Doria^{1

2}, Jessica Vanina Ortiz^{1

2}, Débora Raysa Teixeira de Sousa^{1

2}, Victor Irungu Mwangi¹, Katia do Nascimento Couceiro^{1

2}, Alba Regina Jorge Brandão^{1

2}, Jorge Augusto de Oliveira Guerra^{1

2}, Maria das Graças Vale Barbosa Guerra^{1

2}, João Marcos Barbosa Bemfica Ferreira^{1

2}

Affiliations

¹ Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.
² Gerência de Leishmaniose e Gerencia de Entomologia, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Abstract

Objectives: This study aims to provide a comprehensive analysis of clinical and epidemiological data related to Chronic Chagas Cardiomyopathy (CCC) in the Amazon region of Brazil.

Methods: A review of observational, retrospective, and cross-sectional studies related to Chagas Disease in the Amazon region of Brazil was conducted, and a case series addressing CCC in patients treated at the FMT-HVD outpatient clinic, a reference center for Chagas disease in Brazil, was carried out.

Results: Clinical characteristics of 55 patients from the Amazon region with CCC were described. The most common electrocardiographic alteration observed was abnormal ventricular repolarization (AVR), present in 40% of cases. The most common echocardiographic finding was left ventricular systolic dysfunction (49%), followed by akinesia or hypokinesia of the inferior and/or inferolateral walls (38.1%) and the presence of an apical aneurysm (32.7%).

Conclusions: Overall, this study demonstrates that CCC in the Amazon region presents clinical characteristics and severity that are similar to those observed in other regions. However, certain peculiarities, such as the frequency of right bundle branch block (RBBB) and anterior and septal involvement during the acute phase, require additional investigation to better comprehend the disease in the region. Overall, the study provides crucial clinical insights for the diagnosis and treatment of CCC in the Amazon region.

Keywords: Brazilian Amazon; Chagas disease; LBBB; chronic chagasic cardiopathy; heart failure; left bundle branch block.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Brazil / epidemiology
Chagas Cardiomyopathy* / diagnosis
Chagas Cardiomyopathy* / epidemiology
Chagas Disease* / diagnosis
Chagas Disease* / epidemiology
Cross-Sectional Studies
Humans
Retrospective Studies

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by: Fundação de Amparo à Pesquisa do Estado do Amazonas - FAPEAM - RESOLUÇÃO No. 002/2023. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior CAPES/PROAP 1247/2022.