Evaluating respiratory musculature, quality of life, anxiety, and depression among patients with indeterminate chronic Chagas disease and symptoms of pulmonary hypertension

Abstract

Introduction: Chagas disease (CD) is progressive and incapacitating, especially when cardiopulmonary function is affected. For example, respiratory muscle weakness can cause dyspnea upon exertion and fatigue, which may be exacerbated when it is associated with pulmonary hypertension (PH). The present study aimed to evaluate respiratory musculature, quality of life, anxiety, and depression among patients with indeterminate chronic CD and symptoms of PH. Methods: All individuals completed a clinical evaluation, spirometry, a 6-min walking test, respiratory musculature testing using maximum inspiratory pressure (PImax) and maximum expiratory pressure (PEmax), the Hospital Anxiety and Depression Scale, and the SF-36 questionnaire. Results: We evaluated 107 patients who were assigned to a control group with only CD (G1, 8 patients), a group with CD and possible PH (G2, 93 patients), and a group with CD and echocardiography evidence of PH (G3, 6 patients). The three groups had similar values for PImax and PEmax. Compared to the G1 and G2 groups, the G3 group covered significantly less distance during the 6-min walking test and had a significantly shorter predicted distance (p < 0.05 vs. the G1 group). All three groups had similar values for their spirometry results, Hospital Anxiety and Depression Scale scores, and SF-36 questionnaire results. Conclusions: Patients with indeterminate chronic CD and symptoms of PH did not experience significant impairment in the studied variables, with the exception of the 6-min walking test, which suggests a low exercise tolerance.

Translating Chagasic dilating cardiomyopathy to surgical therapies: An under published global challenge

“…ChHF offers a so far neglected translational model of parasymphatholytic rhythm-driven (early right bundle branch block (RBBB), left anterior fascicular block (LAFB), or other less common dysrhythmias 15,20 ), and eventually non-ischemic cardiac failure, with occasional pulmonary hypertension. 21 Trypanostatic pharmacology 22,23 is evolving and is intertwined with intensive care, new diagnostics, and changing epidemiology, 24–26 as the disease knows no geographical barriers. 27 We could all translate any lessons thus learned to global perioperative healthcare.…”

Targeting the Gut Microbiota in Chagas Disease: What Do We Know so Far?

“…After being produced, TMA can then enter the portal circulation and the liver, where it is further processed to generate TMAO, which triggers heart and kidney dysfunction, such as atherosclerosis, heart failure, renal fibrosis (Brown and Hazen, 2018). Furthermore, studies now acknowledge that CD patients frequently suffer from other comorbid conditions, such as major depressive disorder (MDD) and anxiety (Hueb and Loureiro, 2005;Marchi and Gurgel, 2011;Ozaki et al, 2011;Jackson et al, 2012;Suman et al, 2017). Unsurprisingly, the gut microbiome has been associated with the development of these neuropsychiatric disorders (Mayer et al, 2014;Sharon et al, 2016;Dinan and Cryan, 2017;Cryan et al, 2019).…”

Prevalence and determinants of depressive symptoms in patients with Chagas cardiomyopathy and predominantly preserved cardiac function

“…The disease is endemic in Latin America, with an increased prevalence in non-endemic countries such as the United States and some regions of Europe due to migration to these areas 7,8 . Among patients with this disease, 30% to 40% experience the cardiac form of the infection, which is characterized by constant inflammation, loss of cardiac muscle fibers, systolic dysfunction, functional impairment, and worse prognosis than other cardiopathies 9,10 , which in turn may be associated with mental torment and the onset of depressive symptoms 3,11 .…”