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

Silva, Whesley Tanor; Ávila, Matheus Ribeiro; Oliveira, Lucas Fróis Fernandes de; Figueiredo, Pedro Henrique Scheidt; Lima, Vanessa Pereira de; Bastone, Alessandra de Carvalho; Costa, Fábio Silva Martins da; Mediano, Mauro Felippe Felix; Rocha, Manoel Otávio da Costa

doi:10.1590/0037-8682-0123-2020

Cited by 11 publications

(14 citation statements)

References 48 publications

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“…The 6MWT is a field test that evaluates functional capacity by the distance covered in six minutes 49 . In patients with preserved cardiac function, the 6MWT distance was not correlated with the presence of depressive symptoms 9 . In patients with ChC and systolic dysfunction, the 6MWT distance was correlated with the MLwHFQ total score 38 , 50 , 51 and with the SF-36 domains of physical functioning, role-physical functioning, and bodily pain 50 .…”

Section: Association Between Hrqol and Functional Variables Echocardi...mentioning

confidence: 87%

“…Compared to men, women have more non-life-threatening diseases as well as a higher prevalence of mental disorders such as depression 29 . In CD, female sex was also associated with depressive symptoms 9 . Thus, we believe that female sex is associated with worse HRQoL in patients with CD.…”

Section: Association Between Hrqol and Sociodemographic Or Lifestyle ...mentioning

confidence: 93%

“…Regardless of the clinical form, interest in assessing the health-related quality of life (HRQoL) of patients with CD has increased in recent decades. Affected individuals are surrounded by stigma, depressive symptoms, social vulnerability, economic and sociodemographic disadvantages, and difficulty in accessing health services [8][9][10] , which contributes to the neglected aspect of the disease. Therefore, the present study aimed to discuss the main findings related to HRQoL of patients with CD.…”

Section: Chagas Disease (Cd) Is An Infection Caused By the Protozoanmentioning

confidence: 99%

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The health-related quality of life in patients with Chagas disease: the state of the art

Almeida

Oliveira

Figueiredo

et al. 2022

Rev. Soc. Bras. Med. Trop.

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Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.

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Section: Association Between Hrqol and Functional Variables Echocardi...mentioning

confidence: 87%

Section: Association Between Hrqol and Sociodemographic Or Lifestyle ...mentioning

confidence: 93%

Section: Chagas Disease (Cd) Is An Infection Caused By the Protozoanmentioning

confidence: 99%

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The health-related quality of life in patients with Chagas disease: the state of the art

Almeida

Oliveira

Figueiredo

et al. 2022

Rev. Soc. Bras. Med. Trop.

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“…Although this group of older patients has a low potential for disease progression, it is subject to cardiac changes frequently associated with other cardiovascular diseases such as systemic arterial hypertension and coronary artery disease 46 . Furthermore, the presence of comorbidities such as diabetes mellitus, dyslipidemia, obesity, and depression requires proper clinical management 47 , 48 .…”

Section: Clinical and Prognostic Aspectsmentioning

confidence: 99%

Indeterminate form of Chagas disease: historical, conceptual, clinical, and prognostic aspects

Hasslocher‐Moreno

Xavier

Saraiva

et al. 2021

Rev. Soc. Bras. Med. Trop.

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Chagas disease (CD) remains a serious endemic disease in Latin America and a major public health problem. Because of globalization, the disease has spread to non-endemic areas in the northern hemisphere. In the chronic phase of the disease, most patients present with the indeterminate form (IF), characterized by positive serology for Trypanosoma cruzi, absence of clinical findings, and normal findings in electrocardiogram (ECG). IF was not recognized as a clinical entity until decades after the discovery of the disease, and only in the 1940-50s, it was categorized as a form of CD, and its conceptual definition was ratified in the 1980s. Children, adolescents, and young adults with the IF benefit from etiological treatment and tend to have less progression to heart disease in the long term than the untreated ones. IF patients have an essentially benign clinical condition, and their prognosis can be compared to that of healthy individuals with normal ECG findings. Currently, because of aging, patients with the IF have comorbidities that require attention in health services.

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“…However, 30-40% of infected people progress to chronic determinative forms: cardiac (CARD), digestive (DIG) and cardio-digestive (CARDDIG) (Rassi et al, 2012;Dias et al, 2016b;Nunes et al, 2018;Simões et al, 2018). Mental disorders and neurocognitive abnormalities (anxiety, depression, and memory loss) may parallel other clinical forms of chronic CD (Silva et al, 2020). These clinical forms may result from the hostparasite interplay and growing evidence indicate that the T. cruzi genotypes, which are classified into seven discrete typing units (DTUs) considering a set of genetic, molecular, and immunological biomarkers (Zingales et al, 2009), may also contribute to the clinical outcome; however, there is no consensus on this issue (Zingales, 2018).…”

Section: Chagas Disease: Natural Historymentioning

confidence: 99%

Extracellular Vesicles: Potential Role in Remote Signaling and Inflammation in Trypanosoma cruzi-Triggered Disease

Dantas-Pereira¹,

Menna-Barreto²,

Lannes-Vieira³

2021

Front. Cell Dev. Biol.

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Extracellular vesicles (EVs) act as cell communicators and immune response modulators and may be employed as disease biomarkers and drug delivery systems. In infectious diseases, EVs can be released by the pathogen itself or by the host cells (infected or uninfected), potentially impacting the outcome of the immune response and pathological processes. Chagas disease (CD) is caused by infection by the protozoan Trypanosoma cruzi and is the main cause of heart failure in endemic areas. This illness attracted worldwide attention due to the presence of symptomatic seropositive subjects in North America, Asia, Oceania, and Europe. In the acute phase of infection, nonspecific signs, and symptoms contribute to miss diagnosis and early etiological treatment. In this phase, the immune response is crucial for parasite control; however, parasite persistence, dysregulated immune response, and intrinsic tissue factors may contribute to the pathogenesis of chronic CD. Most seropositive subjects remain in the indeterminate chronic form, and from 30 to 40% of the subjects develop cardiac, digestive, or cardio-digestive manifestations. Identification of EVs containing T. cruzi antigens suggests that these vesicles may target host cells and regulate cellular processes and the immune response by molecular mechanisms that remain to be determined. Parasite-released EVs modulate the host-parasite interplay, stimulate intracellular parasite differentiation and survival, and promote a regulatory cytokine profile in experimental models of CD. EVs derived from the parasite-cell interaction inhibit complement-mediated parasite lysis, allowing evasion. EVs released by T. cruzi-infected cells also regulate surrounding cells, maintaining a proinflammatory profile. After a brief review of the basic features of EVs, the present study focuses on potential participation of T. cruzi-secreted EVs in cell infection and persistence of low-grade parasite load in the chronic phase of infection. We also discuss the role of EVs in shaping the host immune response and in pathogenesis and progression of CD.

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

Cited by 11 publications

References 48 publications

The health-related quality of life in patients with Chagas disease: the state of the art

The health-related quality of life in patients with Chagas disease: the state of the art

Indeterminate form of Chagas disease: historical, conceptual, clinical, and prognostic aspects

Extracellular Vesicles: Potential Role in Remote Signaling and Inflammation in Trypanosoma cruzi-Triggered Disease

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