Prevalence of Trypanosoma cruzi antibodies and inflammatory markers in uncompensated heart failure

Abstract

Introduction: Heart failure (HF) represents the final stage of chronic chagasic cardiomyopathy (CChC). The diagnosis of CChC is based on the demonstration of anti-Trypanosoma cruzi antibodies (aTcAg) and clinical and epidemiological data. In Venezuela, there are no data about the prevalence of chagasic HF. The aim of this study was to determine the epidemiological, clinical, and inflammatory risk factors associated with seronegative or seropositive HF patients. Methods: We performed a cross-sectional study in the Venezuelan central-west states among a healthy rural population and in patients admitted to the emergency room with uncompensated HF. Results: The seroprevalence rates of Trypanosoma cruzi antibodies were 11.2% and 40.1% in the healthy population and in HF patients, respectively. Seropositivity in healthy individuals was associated with age, knowledge on triatomine vectors, and having seen wild reservoirs in the house; in HF patients, with contact with the vector and previous clinical diagnosis of Chagas' disease; and in both groups taken together, with age, knowledge on triatomines, and HF. Seropositive patients had prolonged QRS, decreased ejection fraction, and high serum magnesium, all significant as compared with HF seronegative cases. Left atrium enlargement and ventricular hypertrophy were most frequently observed in HF seronegative patients. CRP, IL6, ILβ1, IL2, and FNTα were elevated in 94.5%, 48%, 17.8%, 13.7%, and 6.9% of HF patients, respectively, but only IL2 levels were associated with chagasic HF. Conclusions: There is a high prevalence of aTcAg in HF patients from the central-west region of Venezuela, and their epidemiological, clinical, and inflammatory features are discreetly different as compared with those of seronegative cases.

Adenosine Deaminase Activity and Serum C-Reactive Protein as Prognostic Markers of Chagas Disease Severity

“…However, CRP is a nonspecific marker of inflammation that noticeably rises in advanced stages of heart disease, disregarding the etiology. This was demonstrated by BRAVO et al (2010) 5 , who reported that CRP levels are elevated in patients with decompensated heart failure. They found no statistically significant differences between patients with serum antibodies for T. cruzi and seronegative patients, notwithstanding, they found that CRP levels were significantly higher in patients in class IV of New York Heart Association functional classification (NYHA IV) when compared with patients in NYHA III, indicating that the CRP serum levels are associated with the severity of the cardiac pathology.…”

“…The increased serum levels of CRP reflect a vascular inflammation state and they are associated with the development of cardiovascular events 4 . Increased levels of serum CRP have been reported in advanced clinical stages of Chagas cardiomyopathy 2 , 18 , 21 , however, this increase was similarly observed in non-chagasic cardiomyopathy 5 .…”

Evaluación preliminar de la prueba comercial “Chagas (Trypanosoma cruzi) IgG-ELISA®” en individuos colombianos

“…Por esta razón, además del grupo de controles sanos, en el presente estudio se incluyeron de forma exploratoria otros grupos de control: a) individuos con factores de riesgo, quienes por vivir o haber vivido en áreas endémicas pueden desarrollar respuesta inmune específica tanto humoral como celular contra el parásito (43); b) individuos infectados con Leishmania, parásito que al igual que T. cruzi pertenece a la familia Trypanosomatidae, y comparte con este algunos de sus epítopos (44,45), y c) individuos con enfermedad cardiaca no infectados, quienes por presentar inflamación o por residir en áreas endémicas pueden tener un ruido de fondo mayor que el de los controles sanos sin estas características (46,47). Los resultados obtenidos indican que si bien estos individuos de control presentaron valores de absorbancia similares a los del grupo de individuos sanos, en la mayoría de los casos se pudo discriminar entre individuos infectados y no infectados.…”

Parasitic (Protozoan) cardiomyopathy: A review and pooled analysis of pathophysiology, diagnosis and clinical management

“…The 27 studies included in this meta-analysis adopted various study designs. The majority were prospective cohort (n = 12; 44%) [161,170,174,220,222,227,229,[231][232][233]235,236] followed by cross- sectional studies (n = 11; 41%) [214][215][216][217][218][219]221,223,226,228,230] and retrospective cohort (n = 4; 14%) [171,224,225,234]. The greater majority (n = 22; 77%) investigated Chagasic CM due to T. cruzi infection and the remaining 23% investigated malaria CM due to Plasmodium infection [161,170,171,174,236].…”