Article
Potential role of transthoracic echocardiography for screening LV systolic dysfunction in patients with a history of dengue infection. A cross-sectional and cohort study and review of the literature
Registro en:
KAAGAARD, Molly D. et al. Potential role of transthoracic echocardiography for screening LV systolic dysfunction in patients with a history of dengue infection. A cross-sectional and cohort study and review of the literature. Plos One, v. 17, n. 11, e0276725, p. 1 - 22, Nov. 2022.
1932-6203
10.1371/ journal.pone.0276725
Autor
Kaagaard, Molly D.
Wegener, Alma
Gomes, Laura C.
Holm, Anna E.
Lima, Karine O.
Matos, Luan O.
Vieira, Isabelle V. M.
Souza, Rodrigo Medeiros de
Vestergaard, Lasse S.
Marinho, Claudio Romero Farias
Santos, Flávia Barreto dos
Biering-Sørensen, Tor
Silvestre, Odilson M.
Brainin, Philip
Resumen
Background
Dengue virus can affect the cardiovascular system and men may be at higher risk of severe
complications than women. We hypothesized that clinical dengue virus (DENV) infection
could induce myocardial alterations of the left ventricle (LV) and that these changes could
be detected by transthoracic echocardiography.
Methodology/Principal findings
We examined individuals from Acre in the Amazon Basin of Brazil in 2020 as part of the
Malaria Heart Study. By questionnaires we collected information on self-reported prior dengue
infection. All individuals underwent transthoracic echocardiography, analysis of left ventricular
ejection fraction (LVEF) and global longitudinal strain (GLS). We included 521
persons (mean age 40±15 years, 39% men, 50% urban areas) of which 253 (49%) had a
history of dengue infection. In multivariable models adjusted for clinical and sociodemographic
data, a history of self-reported dengue was significantly associated with lower LVEF
(β = -2.37, P < 0.01) and lower GLS (β = 1.08, P < 0.01) in men, whereas no significant associations
were found in women (P > 0.05). In line with these findings, men with a history of
dengue had higher rates of LV systolic dysfunction (LVEF < 50% = 20%; GLS < 16% = 17%)
than those without a history of dengue (LVEF < 50% = 7%; GLS < 16% = 8%; P < 0.01 and
0.06, respectively). Conclusions/Significance
The findings of this study suggest that a clinical infection by dengue virus could induce myocardial
alterations, mainly in men and in the LV, which could be detected by conventional
transthoracic echocardiography. Hence, these results highlight a potential role of echocardiography
for screening LV dysfunction in participants with a history of dengue infection. Further
larger studies are warranted to validate the findings of this study.