An observational investigation of patients with coronary microvascular ischemia due to Chagas Disease in comparison with other etiologies for such clinical condition

Abstract

In the usual practice of many Interventional Cardiology services, it is frequently observed that patients are referred for invasive coronary angiography based only on clinical criteria, because of symptoms like angina pectoris. In a substantial proportion of these patients, coronary angiography fails to show obstructions in the sub-epicardial coronary arteries. In this context, by an essential exclusion criterion, the diagnosis turns out to involve probable coronary disease at the microvascular level. Several etiologies are known to lead to this clinical condition. In our country Chagas's disease is one of the most important etiologies for the establishment of coronary microvascular disturbances. However, despite some preliminary initiatives in the fiels, there have been no systematic studies in the population of patients with symptoms suggestive of myocardial ischemia but without sub-epicardial coronary obstructions, whether or not they are carriers of Chagas' disease. Thus, this research project aims to collect clinical data and some simple laboratory tests, in order to advance the knowledge about miocrovascular coronary disease in patients with positive serology indicating chronic infection by the T. cruzi, in comparison with patients who harbor another possible etiology for the clinical condition index of the study. The project will be eminently observational, and its participants will be recruited on spontaneous demand from our Institution for cardiac catheterization and invasive coronary angiography. Its results may contribute decisively to elucidate relevant aspects related to the pathophysiology of microvascular coronary disease in Chagas' disease, as compared to the group of patients with this microvascular alteration of other etiologies, also insufficiently reported in the literature. In addition, this project has the potential to boost two others in development in our laboratory of Hemodynamics and Interventional Cardiology, one diagnostic and another therapeutic. (AU)