Arq Bras Cardiol: Imagem cardiovasc 2018; 31(3): 183-190

Echocardiographic Evaluation of Late Cardiac Abnormalities Caused by the Chikungunya Fever

DOI: 10.5935/2318-8219.20180027

Abstract

Background

Chicungunya fever causes highly debilitating joint pains. Complications are rare and may affect the cardiovascular system.

Objective

To evaluate, with echocardiography and two-dimensional strain, the cardiovascular changes in the chronic phase of the Chikungunya infection.

Methods

The study included 32 patients, mean age 56 ± 14 years divided into Group A, with < 12 months evolution (12 patients) and Group B, with ≥ 12 months evolution (20 patients). The cardiac dimensions, left ventricular end-diastolic volume indexed to body surface, left ventricular ejection fraction, left ventricular global longitudinal strain and left atrial longitudinal strain were determined. The groups were compared using unpaired analysis. The p significance was < 0.05.

Results

Most Group A patients presented diffuse hypocontratility and decreased left ventricular ejection fraction (45.5 ± 10.4%) with normal left ventricular diastolic indexed volume (58.7 ± 24.9 mL/m²). Most Group B patients presented diffuse hypocontratility (ejection fraction 38.2 ± 6.4%) and increased left ventricular diastolic indexed volume (88.3 ± 26.4 mL/m²). There was segmental changes in 22% of the patients, and hypertrophy or remodelling in seven cases of each Group. There was decreased global longitudinal strain in both Groups (-11.9 ± 4.4% in Group A and -10.3 ± 3.8% in Group B). Lef atrial longitudinal strain were 37.9 ± 17.3% in Group A and 27.5 ± 15.2% in Group B. Patients with pericarditis had normal left ventricular dimensions and function.

Conclusion

The cardiac complications of Chikungunya fever was diffuse hypocontratility with left ventricular normal size observed in the first year of chronic evolution and diffuse hypocontratility with left ventricular dilation observed in later evolution. Patients with pericardial thickening did not present myocardial issues. Echocardiography can be used as an important tool in patients with Chikungunya fever, since it can detects early abnormalities in the cardiovascular system. (Arq Bras Cardiol: Imagem cardiovasc. 2018;31(3):183-190)