Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease

Mendes, Verônica Gonçalves; Rimolo, Lorena; Lima, Ana Carolina Bastos de; Ferreira, Roberto Rodrigues; Oliveira, L.; Nisimura, Líndice Mitie; Horita, Samuel Iwao; Costa, Andréa Rodrigues da; Silva, Gilberto Marcelo Sperandio da; Sangenis, Luiz Henrique Conde; Mendes, Fernanda de Souza Nogueira Sardinha; Sousa, Andréa Silvestre de; Veloso, Henrique Horta; Holanda, Marcelo Teixeira de; Mediano, Mauro Felippe Felix; Waghabi, Mariana Caldas; Garzoni, Luciana Ribeiro; Moreira, Otacílio C.; Britto, Constança; Cunha, Ademir Batista da; Hasslocher‐Moreno, Alejandro Marcel; Saraiva, Roberto Magalhães

doi:10.1161/jaha.122.028810

Cited by 8 publications

(11 citation statements)

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“…Brain natriuretic peptide (BNP), cardiac troponin I, matrix metalloproteinases 2 and 9 (MMP-2 and MMP-9), transforming growth factor β1 (TGF-β1), and tumour necrosis factor (TNF) blood levels were previously investigated in this project. 17 IL-17 blood levels were higher in all cardiac form groups than in patients with the indeterminate form. IL-6 presented a tendency for higher blood levels in both initial stages of the cardiac form (p = 0.06) and advanced stages of the cardiac form (p = 0.05) than in patients with the indeterminate form.…”

Section: Resultsmentioning

confidence: 73%

“…Design and study subjects - This is a cross-sectional secondary analysis of a previous study approved by the local ethical committee on 01/27/2014 under number 515851 whose main paper was already published. 17 …”

Section: Methodsmentioning

confidence: 99%

“…Data from adult patients with chronic CD who had been included in the previous study between July 2014 and March 2017 and who had had blood samples collected for T. cruzi quantitative PCR (qPCR) were analysed in the present paper. 17 Briefly, from 402 patients, 11 did not return for the index echocardiogram, 30 were excluded due to several reasons described in Figure , and other 28 patients did not have blood samples collected for T. cruzi qPCR. The final studied population was composed of 333 patients ( Figure ).…”

Section: Methodsmentioning

confidence: 99%

“…Trypanosoma cruzi PCR - T. cruzi PCR was performed as previously described. 17 Briefly, ten millilitres of whole blood samples were obtained from each patient. The samples were processed for DNA extraction using the High Pure PCR Template Preparation kit (Roche Diagnostics Corp., Indianapolis, IN).…”

Section: Methodsmentioning

confidence: 99%

“…The importance of the persistence of the parasite for CD progression was suggested by several findings, such as a more frequent identification of the parasite in the bloodstream of patients with the cardiac form than in those without the cardiac form, 14 , 15 and a worse prognosis in patients with parasitaemia identified by haemoculture 15 and molecular methods. 16 , 17 …”

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confidence: 99%

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Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease

de Lima,

Mendes,

Ferreira

et al. 2023

Mem. Inst. Oswaldo Cruz

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BACKGROUND A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.

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Section: Resultsmentioning

confidence: 73%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease

de Lima,

Mendes,

Ferreira

et al. 2023

Mem. Inst. Oswaldo Cruz

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A guide for the generation of repositories of clinical samples for research on Chagas disease

Martínez-Peinado,

Gabaldón-Figueira,

Rodrigues Ferreira

et al. 2024

PLoS Negl Trop Dis

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Chagas disease, caused by the parasite Trypanosoma cruzi, affects over 6 million people, mainly in Latin America. Two different clinical phases, acute and chronic, are recognised. Currently, 2 anti-parasitic drugs are available to treat the disease (nifurtimox and benznidazole), but diagnostic methods require of a relatively complex infrastructure and trained personnel, limiting its widespread use in endemic areas, and the access of patients to treatment. New diagnostic methods, such as rapid tests (RDTs) to diagnose chronic Chagas disease, or loop-mediated isothermal amplification (LAMP), to detect acute infections, represent valuable alternatives, but the parasite’s remarkable genetic diversity might make its implementation difficult. Furthermore, determining the efficacy of Chagas disease treatment is complicated, given the slow reversion of serological anti-T. cruzi antibody reactivity, which may even take decades to occur. New biomarkers to evaluate early therapeutic efficacy, as well as diagnostic tests able to detect the wide variety of circulating genotypes, are therefore, urgently required. To carry out studies that address these needs, high-quality and traceable samples from T. cruzi-infected individuals with different geographical backgrounds, along with associated clinical and epidemiological data, are necessary. This work describes the framework for the creation of such repositories, following standardised and uniform protocols, and considering the ethical, technical, and logistic aspects of the process. The manual can be adapted according to the resources of each laboratory, to guarantee that samples are obtained in a reproducible way, favouring the exchange of data among different work groups, and their generalizable evaluation and analysis. The main objective of this is to accelerate the development of new diagnostic methods and the identification of biomarkers for Chagas disease.

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Exploring the Historical Background and Clinical Implications of Electrocardiogram in the Context of Chagas Disease Research

Hasslocher-Moreno,

Saraiva,

Silva Júnior

et al. 2023

Rev. Soc. Bras. Med. Trop.

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Chagas disease (CD) remains one of the most significant endemic diseases in Latin America. Approximately 30% of individuals with CD develop the cardiac form, the main determinant of morbidity and mortality, which is characterized by typical electrocardiogram (ECG) changes caused by chronic chagasic cardiopathy (CCC). This review accentuates to how crucial it is for research teams and reference centers that treat patients with CD to standardize ECG in CCC. This was a non-systematic review of the literature. ECG is the most widely used examination in the diagnosis and evaluation of CCC, and it is also employed in epidemiological surveys, risk stratification for cardiovascular events and death, and monitoring the clinical progression of the disease. Carlos Chagas and Eurico Villela published the first work addressing CCC in 1922. Other works followed, including the study by Evandro Chagas' which was the first to perform ECG in CD, culminating in Francisco Laranja's seminal work in 1956. Since the 1980s, standardizations and ECG reading codes for CD have been established. This standardization aimed to code complex arrhythmias and characteristic ventricular conduction disorders and standardize ECG readings for clinical and epidemiological studies in CD. Nearly all existing electrocardiographic abnormalities can be found in CD, with a predominance of abnormalities in the formation and conduction of cardiac stimuli. The complex and heterogeneous substrate of CD with varied electrocardiographic manifestations poses a significant challenge when comparing studies involving patients with CCC, emphasizing the need for ECG standardization in CD.

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Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease

Cited by 8 publications

References 59 publications

Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease

Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease

A guide for the generation of repositories of clinical samples for research on Chagas disease

Exploring the Historical Background and Clinical Implications of Electrocardiogram in the Context of Chagas Disease Research

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