Cardiac autonomic function in chagasic elderly patients in an endemic area: A time and frequency domain analysis approach

Resende, Luiz Antônio Pertili Rodrigues de; Molina, Rodrigo Juliano; Ferreira, Bruno Doriguetto Couto; Carneiro, Aldo César; Ferreira, Luiz Alberto Andrade; Silva, Valdo José Dias da; Prata, Áluízio; Correia, Dalmo

doi:10.1016/j.autneu.2006.05.005

Cited by 20 publications

(28 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Chagasics with arterial hypertension also present impaired cardiac parasympathetic modulation, apparently to the same extension as chagasics without hypertension 39 . However, a sample of elderly chagasics with the indeterminate form of the disease did not showed any alterations in cardiac autonomic function as compared with healthy elderly subjects 40 . Contrasting with this finding, elderly chagasics below 70 years, but not those older, with an uncharacterised form of the disease, show reduced vagal modulation 41 .…”

Section: Cardiac Autonomic Nervous System In Chagas Diseasementioning

confidence: 72%

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Junqueira Junior

2012

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

show abstract

Section: Cardiac Autonomic Nervous System In Chagas Diseasementioning

confidence: 72%

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Junqueira Junior

2012

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

show abstract

“…These investigations have demonstrated that, the chronotropic responses to cardiac autonomic tests are apparently impaired in the indeterminate form of the disease. However, we [7][8][9]20,21,37 and other investigators 16 have found that chagasic patients who are in different stages of natural history of the disease may have normal, abnormal 2 or even enhanced responses to conventional cardiac autonomic tests 15,27 . Moreover, the frequency and time domain indexes of parasympathetic modulation may be suppressed in the supine position, but become similar to controls in the standing position and while performing isometric exercise 6,24,27,45 .…”

Section: Introductionmentioning

confidence: 58%

Muscarinic antibodies and heart rate responses to dynamic exercise and to the Valsalva maneuver in chronic chagasic patients

Neves¹,

Bacilio²,

Berrueta

et al. 2013

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

SUMMARYWe have studied the cardiac chronotropic responses to the Valsalva maneuver and to dynamic exercise of twenty chronic chagasic patients with normal left ventricular function and no segmental wall abnormalities by two-dimensional echocardiogram. The absolute increase in heart rate of the patients (∆ = 21.5 ± 10 bpm, M±SD) during the maneuver was significantly diminished when compared to controls (∆ = 31.30 ± 70, M±SD, p = 0.03). The minimum heart rate (58.24 ± 8.90 vs. 62.80 ± 10, p = 0.68) and the absolute decrease in heart rate at the end of the maneuver (∆ = 38.30 ± 13 vs. ∆ = 31.47 ± 17, p = 0.10) were not different from controls. The initial heart rate acceleration during dynamic exercise (∆ = 12 ± 7.55 vs. ∆ = 19 ± 7.27, M±SD, p = 0.01) was also diminished, but the heart rate recovery during the first ten seconds was more prominent in the sero-positive patients (Median: 14, Interquartile range: (9.75-17.50 vs. 5(0-8.75, p = 0.001). The serum levels of muscarinic cardiac auto-antibodies were significantly higher in the chagasic patients (Median: 34.58, Interquartile Range: 17-46.5, Optical Density) than in controls (Median: 0, Interquartile Range: 0-22.25, p = 0.001) and correlated significantly and directly (r = 0.68, p = 0.002) with early heart rate recovery during dynamic exercise. The results of this investigation indirectly suggest that, the cardiac muscarinic auto-antibodies may have positive agonist effects on parasympathetic heart rate control of chagasic patients.

show abstract

“…In the case of the endemic area of Água Comprida, vectorial transmission of Chagas disease has been interrupted since 1985 and continues that way through the present. 37,38 At the present, there are no solid explanations that justify this difference of behavior, although some hypotheses try to associate it to different factors connected to the infective sampling of T. cruzi , the socioeconomic status of the patient, or the immune response in the interaction with this parasite. 39 The clinical diagnosis of the 73 individuals was not possible, because since 1980, several clinical, epidemic, immunological, and therapeutic studies were performed in this area.…”

Section: Discussionmentioning

confidence: 99%

Familial Analysis of Seropositivity to Trypanosoma cruzi and of Clinical Forms of Chagas Disease

Silva-Grecco¹,

Balarin²,

Correia³

et al. 2010

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

Abstract.A cross-sectional study was carried out in Água Comprida, MG, Brazil, a region previously endemic to Chagas disease whose vectorial transmission was interrupted around 20 year ago. A total of 998 individuals were examined for anti-Trypanosoma cruzi antibodies. Seropositivity was observed in 255 subjects (25.5%), and 743 subjects were negative. Forty-one families with 5-80 individuals with similar environmental conditions were selected for familial analysis. In 15 families, seropositivity to T. cruzi was observed in > 50% of individuals. The segregation analysis confirmed family aggregation for the seropositivity to the T. cruzi . Heart commitment was the major clinical form observed, and in six families, > 50% of the individuals display cardiopathy that may be attributed to T. cruzi infection. Our results support the hypothesis that there is a family aggregation for the seropositivity but without the effect of one major gene.

show abstract

Cardiac autonomic function in chagasic elderly patients in an endemic area: A time and frequency domain analysis approach

Cited by 20 publications

References 30 publications

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Muscarinic antibodies and heart rate responses to dynamic exercise and to the Valsalva maneuver in chronic chagasic patients

Familial Analysis of Seropositivity to Trypanosoma cruzi and of Clinical Forms of Chagas Disease

Contact Info

Product

Resources

About