Biochemical characterization of myocardial damage in chronic chagas' disease

Abstract

SummaryBackground: In the early asymptomatic stages of cardioniyopathy in chronic Chagas' disease, septa1 endomyocardial biopsies disclose multiple evidence of evolving myocardial damage. Detection of signs of an active myocardiopathic process may allow a better understanding of the evolution of this and other related dilated cardiomyopathies and provide a means for evaluation of the result of future therapeutic schemes.Hypothesis: This study was designed to explore whether cellular damage caused by Chagas' disease is reflected by changes of certain serum electrolytes, enzymes, and glycoproteins associated with myocardial metabolism, especially in the coronary sinus into which the blood just metabolized by the heart is drained.Merhods: The study included 47 patients (35 men and 12 women, average age 40 years) with positive complement fixation reaction and hemagglutination test for Chagas' disease. The study protocol included medical records, electrocardiographic (ECG) recordings, routine laboratory analysis, chest x-rays, noninvasive cardiac examinations, and cardiac catheterization.Results: In this study, we determined the concentration or activity of 9 electrolytes, 5 glycoprotein fractions, and 12 enzymes related to cardiac metabolism in blood from the coronary sinus, the superior vena cava, the pulmonary and femoral

Update on Chagas' disease in Mexico

“…The chronic phase of the disease develops in about 30-40% of infected patients, 9,10 and corresponds to the slow destruction of infected cells by the amastigote form of the parasite. 11 The primary targets are the heart, and to a lesser extent the gut and nervous tissues, 10 and clinical signs of myocarditis generally appear in patients aged between 30-50 years. Some cardiac alterations such as extrasystoles or atria ventricular blocks are observed with a relatively high frequency, but none is totally specific of chagasic cardiomyopathy.…”

Chronic Chagas disease: from basics to laboratory medicine

“…However, due primarily to their insufficient sensitivity, these markers were not able to indicate myocardial alterations, such as focal inflammation and small disseminated necrosis in the chagasic heart. In two studies that addressed the problems of sensitivity and specificity by analyzing markers in blood samples obtained from the coronary sinus, superior cava vein and pulmonary artery, enzyme release, mainly of isocitrate dehydrogenase and α HBDH, was shown to be evident in Chagas heart patients [176,177] .…”