SEDE SANTA CRUZ
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Item Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain: Win, Miranda prediction of Chagas cardiomyopathy(IJC Heart & Vasculature, 2022) Win, Sithu; Miranda-Schaeubinger, Monica; Durán Saucedo, Ronald Gustavo; Carballo Jimenez, Paula; Flores, Jorge; Mercado Saavedra, Brandon; Camila Telleria, Lola; Raafs, Anne; Verastegui, Manuela; Bern, Caryn; Tinajeros, Freddy; Heymans, Stephane; Marcus, Rachel; Gilman, Robert H.; Mukherjee, MonicaBackground: Chagas disease is an endemic protozoan disease with high prevalence in Latin America. Of those infected, 20–30% will develop chronic Chagas cardiomyopathy (CCC) however, prediction using existing clinical criteria remains poor. In this study, we investigated the utility of left ventricular (LV) echocardiographic speckle-tracking global longitudinal strain (GLS) for early detection of CCC. Methods and results: 139 asymptomatic T. cruzi seropositive subjects with normal heart size and normal LV ejection fraction (EF) (stage A or B) were enrolled in this prospective observational study and underwent paired echocardiograms at baseline and 1-year follow-up. Progressors were participants classified as stage C or D at follow-up due to development of symptoms of heart failure, cardiomegaly, or decrease in LVEF. LV GLS was calculated as the average peak systolic strain of 16 LV segments. Measurements were compared between participants who progressed and did not progress by two-sample t-test, and the odds of progression assessed by multivariable logistic regression. Of the 139 participants, 69.8% were female, mean age 55.8 ± 12.5 years, with 12 (8.6%) progressing to Stage C or D at follow-up. Progressors tended to be older, male, with wider QRS duration. LV GLS was −19.0% in progressors vs. –22.4% in non-progressors at baseline, with 71% higher odds of progression per +1% of GLS (adjusted OR 1.71, 95% CI 1.20–2.44, p = 0.003). Conclusion: Baseline LV GLS in participants with CCC stage A or B was predictive of progression within 1-year and may guide timing of clinical follow-up and promote early detection or treatment.Item Trypanosomacruzi-Infected Pregnant Women without Vector Exposure Have Higher Parasitemia Levels: Implications for Congenital Transmission Risk(2015-01-14) Rendell, Victoria R.; Gilman, Robert H.; Valencia, Edward; Galdos-Cardenas, Gerson; Verastegui, Manuela; Sanchez, Leny; Acosta, Janet; Sanchez, Gerardo; Ferrufino, Lisbeth; LaFuente, Carlos; Abastoflor, Maria del Carmen; Colanzi, Rony; Bern, CarynCongenital transmission is a major source of new Trypanosoma cruzi infections, and as vector and blood bank control continue to improve, the proportion due to congenital infection will grow. A major unanswered question is why reported transmission rates from T.cruzi-infected mothers vary so widely among study populations. Women with high parasite loads during pregnancy are more likely to transmit to their infants, but the factors that govern maternal parasite load are largely unknown. Better understanding of these factors could enable prioritization of screening programs to target women most at risk of transmission to their infants.Item Sustained Domestic Vector Exposure Is Associated With Increased Chagas Cardiomyopathy Risk but Decreased Parasitemia and Congenital Transmission Risk Among Young Women in Bolivia(Oxford University Press on behalf of the Infectious Diseases Society of America, 2015-06-02) Kaplinski, Michelle; Jois, Malasa; Galdos-Cardenas, Gerson; Rendell, Victoria R.; Shah, Vishal; Do, Rose Q.; Marcus, Rachel; Burroughs Pena, Melissa S.; Abastoflor, Maria del Carmen; LaFuente, Carlos; Bozo, Ricardo; Valencia, Edward; Verastegui, Manuela; Colanzi, Rony; Gilman, Robert H.; Bern, Caryn