Disfunção endotelial venosa em pacientes com doença de Chagas sem insuficiência cardíaca

Abstract

Original Article M a i l i n g A d d r e s s : R o d r i g o D el l a M e á P l e n t z • R u a J o ã o M a n o e l , 1 3 5 2 -9 8 1 0 -5 1 7 0 -C r u z A l t a , R S -B r a z i l E-mail: roplentz@yahoo.com. OBJECTIVETo analyze the venous endothelial function in Chagas' disease patients without heart failure. METHODSThe Chagas' disease Group (G1) was composed by 14 women and 2 men aged 46 ± 2,7 and the Control Group (G0) by 7 women and 1 man matched by age, weight and height. Dorsal Hand Vein Compliance Technique was used to evaluate the venous endothelial function. Crescent doses of phenylephrine were infused to get a 70% preconstriction of the vein; after that, acetylcholine and sodium nitroprusside were respectively administrated to analyze the endothelium-dependent and -independent venodilation. RESULTSNo significant systemic hemodynamic changes were observed in both groups during the experiment. The necessary phenylephrine dose to reach 70% preconstriction of the vein was signifi cantly higher in the G1 (1116 ± 668,2 ng/ml) compared to G0 (103 ± 28 ng/ml) p = 0,05. The endothelium-dependent venous dilation was signifi cantly lower in G1 (65,5 ± 8%) compared to G0 (137 ± 20 %) p = 0,009. No difference was observed in the endothelium-independent venous dilatation between groups.

Ativação imune-inflamatória na insuficiência cardíaca

“…Despite the broad spectrum of myocardial involvement, alterations in the endothelial function, in the oxidative balance, and in the homeostasis of the immune system are already present in asymptomatic individuals, and become marked in patients with severe ventricular dysfunction 37,38 .…”

O papel do betabloqueador na miocardiopatia chagásica experimental: avaliação morfo-funcional

“…Esta miocardite é caracterizada por infiltrado de macrófagos (50%), células B (10%) e células T (40%) com predomínio de CD 8 . Linhagens destas células T produzem IFN-y e TNF-α, que promovem mais danos ao miocárdio e evolução da sua disfunção 19 . Também são liberadas quimoquinas e óxido nítrico, que participam da agressão tecidual.…”