The aim of the present study was to carry out a quantitative assessment of the regional left ventricular wall motion and diastolic function of patients with Chagas disease in different clinical stages. Twenty patients with positive immunofluorescence tests for Chagas disease were studied. Eight patients were asymptomatic (class I), 9 patients had electrocardiographic abnormalities (class II) and 3 patients had heart failure (class III). The control group consisted of 10 normal subjects. 2D echocardiographic images from parasternal and apical views were analysed quantitatively using a previously validated method for the assessment of the regional wall motion of the left ventricle. Diastolic flow velocities and times at mitral valve level were analysed using pulsed wave Doppler. Patients with Chagas disease showed marked wall motion abnormalities in the posterobasal segment compared with controls. These abnormalities were evident even in class I patients. The number of affected segments was higher in class II and class III. "A" wave velocity was greater in patients than in controls (0.67 +/- 0.17 and 0.49 +/- 0.08 m/s, p = 0.01 respectively) but the pattern of diastolic flow velocity was non specific. In conclusion, regional left ventricular wall motion abnormalities are common in early stages of Chagas disease suggesting that myocardial activity of the disease is present even during the asymptomatic period.
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