DF826LN
Área: Misceláneo
Tipo de presentacion: Poster

Dumont S M¹, Pacheco J M S², Batista S X C³, Nunes S³, Chaves A T⁴, Nascimento B R⁵, Nunes M D C P⁵, Marino V S P⁶, Rocha M O D C⁵

¹Departamento de Anatomia e Imagem, Faculdade de Medicina, Universidade Federal de Minas Gerais.
²Setor de Medicina Nuclear, Faculdade de Medicina, Universidade Federal de Minas Gerais.
³Setor de Medicina Nuclear Universidade Federal de Minas Gerais.
⁴Setor de Imunologia Universidade Federal de Minas Gerais.
⁵Departamento de Clínica Médica Universidade Federal de Minas Gerais.
⁶Departamento de Anatomia e Imagem Universidade Federal de Minas Gerais.

Introduction

Chronic Chagas disease can affect heart or digestive tract, one pathogenic mechanism includes neurogenic damage. Autonomic involvement association of heart and digestive tract has not been proven. Objective: Evaluate esophageal autonomic denervation using RETS, in patients with ChD with different degrees of cardiac involvement and healthy controls.

Methods

Cross-sectional study, patients recruited at Chagas Outpatient Clinic HC/UFMG and classified in indeterminate, cardiac form. Condition that interfere RETS results were excluded. Ethics Committee approved protocol. Patients and controls underwent RETS described by Russel et al., 1981.

Results

89 individuals analyzed, 20 healthy control (HC), 32 indeterminate form (IF) and 37 Chagas heart disease (ChHD). We observed a difference in esophageal emptying time (EET) and percentage of emptying per group (p-value <0.05). The lowest median EET was observed for the HC (median = 8.5), followed by IF (median = 16.1). The highest median occurred for ChH (median = 47.8). Regarding the percentage of emptying, a higher median value was observed for HC (median = 92.3), followed by the IF (median = 86.0). The lowest value was observed in the ChHD (median = 60.4).

Discussion

The pathogenesis of cardiac ChD includes neurogenic mechanisms²;.Varying degrees of parasympathetic and / or sympathetic dysfunction is associated with ventricular arrhythmias. In digestive form, parasympathetic denervation is well established and can be studied by RETS³. As hypothesis, we assumed that denervation of the myenteric plexus is part of a global pathogenetic process in ChD, changes in the esophageal transit would be progressively more evident in more advanced stages of the disease. This study findings corroborate our hypothesis.

Conclusion

RETS may be a sensitive method for the detection of parasympathetic denervation of the esophagus that showed correlation with different cardiac involvement of ChD and may be correlated with prognostic indicators, as arrhythmogenicity, in complementary studies.

References

¹Validade do conceito de forma indeterminada de doença de Chagas. Revista da Sociedade Brasileira de Medicina Tropical, v. 18, p. 46-46, 1985.
²ROCHA, M. O.; RIBEIRO, A. L.; TEIXEIRA, M. M. Clinical management of chronic Chagas cardiomyopathy. Front. Biosci., v. 8, p. e44-e54, 2003.
³RIBEIRO, A. L. et al. Diagnosis and management of Chagas disease and cardiomyopathy. Nat Rev Cardiol, v. 9, n. 10, p. 576-589, 2012. Associação de Apoio a Residencia Médica de Minas Gerais - AREMG