Exercise testing in the latent phase of chagas' disease

Pereira, Mauricio; Brito, F. S.; Ambrose, John A.; Pereira, Carlos Britto; Levi, Guido Carlos; Neto, Vicente Amato; Martinez, Eva E.

doi:10.1002/clc.4960070503

Cited by 13 publications

(3 citation statements)

References 10 publications

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“…In their seminal study published in 1922, Chagas and Villela described a peculiar absence of chronotropic response to atropine in Chagas cardiopathy patients 3 . Further studies confirmed that ChD patients might present chronotropic incompetence during dynamic and isometric exercise 4–8 or dobutamine stress 9 . Nonetheless, the physiopathology of chronotropic incompetence in ChD is far from being elucidated.…”

mentioning

confidence: 99%

Chronotropic Incompetence and Abnormal Autonomic Modulation in Ambulatory Chagas Disease Patients

Rocha

Lombardi

Rocha³

et al. 2006

Noninvasive Electrocardiol

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mentioning

confidence: 99%

Chronotropic Incompetence and Abnormal Autonomic Modulation in Ambulatory Chagas Disease Patients

Rocha

Lombardi

Rocha³

et al. 2006

Noninvasive Electrocardiol

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“…A previous study found that heart rate (beats per minute) in T. cruzi experimentally infected dogs was significantly higher than control dogs during acute infection, but no difference was found during the indeterminate phase [33]. Chronic Chagas cardiomyopathy in humans can cause a decreased response to exercise and stress due to failure of cardiac compensation [61,62]. However, benefits of exercise training in chronic heart failure patients has been shown, and new research suggests that regular exercise could assist with cardiac function in chronic Chagas disease in humans [63,64].…”

Section: Discussionmentioning

confidence: 99%

Selected cardiac abnormalities in Trypanosoma cruzi serologically positive, discordant, and negative working dogs along the Texas-Mexico border

et al. 2020

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Background: Chagas disease is increasingly recognized in the southern U.S., where triatomine vectors transmit Trypanosoma cruzi among wildlife and domestic dogs with occasional vector spillover to humans. As in humans, clinical outcome in dogs is variable, ranging from acute death to asymptomatic infections or chronic heart disease. In order to characterize cardiac manifestations of T. cruzi infections, we tracked a cohort of naturally-infected dogs and a matched cohort of uninfected dogs. We hypothesized that selected measures of cardiac disease (abnormal rate, abnormal rhythm, and elevated cardiac troponin I (cTnI; a biomarker of cardiac injury)) would occur more commonly in infected than uninfected dogs matched by age, breed, sex and location. In addition to the clearly positive and negative dogs, we specifically tracked dogs with discordant test results across three independent serological assays to gather clinical data that might elucidate the infection status of these animals and inform the utility of the different testing approaches. Results: We placed an ambulatory ECG monitor (Holter) on 48 government working dogs and analyzed 39 successful recordings that met length and quality criteria from 17 T. cruzi-infected, 18 uninfected dogs and 4 dogs with discordant results. Overall, 76.5% of positive, 100.0% of discordant, and 11.1% of negative dogs showed > 1 ECG abnormality (p < 0.0001), and positive and discordant dogs had a higher mean number of different types of ECG abnormalities than negative dogs (p < 0.001-0.014). The most common cardiac abnormalities included supraventricular and ventricular arrhythmias and atrioventricular block. Positive dogs had higher serum concentrations of cTnI than both negative dogs (p = 0.044) and discordant dogs (p = 0.06). Based on dog handler reports, nearly all (4/5; 80%) dogs with reported performance decline or fatigue were T. cruzi-infected dogs.Conclusions: Further understanding cardiac manifestations in dogs naturally infected with T. cruzi is critical for prognostication, establishing a baseline for drug and vaccine studies, and better understanding of zoonotic risk.

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“…The sample size used was implemented to detect the prevalence of EIVA in ChD patients based on a previous study (23) .…”

Section: Discussionmentioning

confidence: 99%

Exercise-induced ventricular arrhythmias and vagal dysfunction in Chagas disease patients with no apparent cardiac involvement

Costa

Nunes

Souza

et al. 2015

Rev. Soc. Bras. Med. Trop.

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Introduction: Exercise-induced ventricular arrhythmia (EIVA) and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD) patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement. Methods: A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5) years, and 38 healthy individuals, aged 44.0 (9.2) years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests. Results: The occurrence of EIVA was higher in the chagasic group (48%) than in the control group (23.7%) during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was signifi cantly lower in the chagasic individuals compared with the control group. Conclusions: ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease.

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Exercise testing in the latent phase of chagas' disease

Cited by 13 publications

References 10 publications

Chronotropic Incompetence and Abnormal Autonomic Modulation in Ambulatory Chagas Disease Patients

Chronotropic Incompetence and Abnormal Autonomic Modulation in Ambulatory Chagas Disease Patients

Selected cardiac abnormalities in Trypanosoma cruzi serologically positive, discordant, and negative working dogs along the Texas-Mexico border

Exercise-induced ventricular arrhythmias and vagal dysfunction in Chagas disease patients with no apparent cardiac involvement

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