Chronotopic and blood pressure response to oral glucose load in chagas' disease

Guariento, Maria Elena; Olga, Elza; Muscelli, Ana; Gontijo, José Antônio Rocha

doi:10.1590/s1516-31801994000300006

Cited by 12 publications

(11 citation statements)

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“…In a previous study, Guariento et al 7 already observed the same situation in patients with the indeterminate form of Chagas' disease. Glucose metabolism, including insulin release, is related, at least partly, to autonomic nervous system integrity.…”

Section: Discussionsupporting

confidence: 63%

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Pressão arterial, respostas metabólicas e autonômicas à insulina e infusão de intralipid® em pacientes chagásicos

Silva¹,

Santos²,

Mostarda³

et al. 2012

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 63%

“…In a study involving chagasic patients, Guariento et al 7 showed an impaired BP and heart rate response to a glucose overload, a stimuli for insulin production.…”

Section: Discussionmentioning

confidence: 99%

Pressão arterial, respostas metabólicas e autonômicas à insulina e infusão de intralipid® em pacientes chagásicos

Silva¹,

Santos²,

Mostarda³

et al. 2012

Arq. Bras. Cardiol.

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“…Thus, in considering potential mechanisms for reduced insulin secretion in the setting of T. cruz i infection, pancreatic nerve cells have been examined (dos Santos et al 1999a; dos Santos et al 2004; Guariento et al 1994; Guariento et al 1993; Oliveira et al 1993). In fact, it was suggested that neuritis and autonomic dysfunction were etiologic factors for pancreatic disease in this setting (dos Santos et al 2004).…”

Section: Evidence From Human Studiesmentioning

confidence: 99%

“…In a study designed to determine the effects of Chagas disease on cardiovascular responses to a glucose load, decreased insulin response in a subgroup of patients was observed (Guariento et al 1994). Patients with the indeterminate form of the disease were subjected to an OGTT and changes in heart rate, blood pressure as well as the “double cross index” (systolic blood pressure multiplied by heart rate) were measured.…”

Section: Evidence From Human Studiesmentioning

confidence: 99%

Alterations in pancreatic β cell function and Trypanosoma cruzi infection: evidence from human and animal studies

et al. 2016

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The parasite Trypanosoma cruzi causes a persistent infection, Chagas disease, affecting millions of persons in endemic areas of Latin America. As a result of immigration, this disease has now been diagnosed in non-endemic areas worldwide. Although, the heart and gastrointestinal tract are the most studied, the insulin secreting β cell of the endocrine pancreas is also a target of infection. In this review, we summarize available clinical and laboratory evidence to determine whether T. cruzi-infection-mediated changes of β cell function is likely to contribute to the development of hyperglycemia and diabetes. Our literature survey indicates that T. cruzi infection of humans and of experimental animals relates to altered secretory behavior of β cells. The mechanistic basis of these observations appears to be a change in stimulus-secretion pathway function rather than the loss of insulin producing β cells. Whether this attenuated insulin release ultimately contributes to the pathogenesis of diabetes in human Chagas disease however, remains to be determined. Since the etiologies of diabetes are multifactorial including genetic and life-style factors, the use of cell- and animal-based investigations, allowing direct manipulation of these factors, are important tools in testing if reduced insulin secretion has a causal influence on diabetes in the setting of Chagas disease. Long-term clinical investigations will be required to investigate this link in humans.

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“…Moreover, considering the intricate relationship between different organ systems and processes, the proper cardiac autonomic dysfunction is expected to be correlated with metabolic, hormonal and functional renal disturbances. Indeed, cardiac autonomic dysfunction has been observed in chagasic subjects with either indeterminate or cardiac forms of the disease and in experimentally Trypanosoma cruzi-infected animals simultaneously with altered osmoregulation dependent on the antidiuretic hormone response 85 , altered hydroelectrolytic balance 86 and altered glucose tolerance 87 .…”

Section: Other Possible Effects Of Autonomic Dysfunctionmentioning

confidence: 99%

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Junqueira Junior

2012

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

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Chronotopic and blood pressure response to oral glucose load in chagas' disease

Cited by 12 publications

References 0 publications

Pressão arterial, respostas metabólicas e autonômicas à insulina e infusão de intralipid® em pacientes chagásicos

Pressão arterial, respostas metabólicas e autonômicas à insulina e infusão de intralipid® em pacientes chagásicos

Alterations in pancreatic β cell function and Trypanosoma cruzi infection: evidence from human and animal studies

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

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