Carvedilol atenua o estresse oxidativo na cardiopatia chagásica crônica

Budni, Patrícia; Pedrosa, Roberto Coury; Garlet, Thais Regina; Dalmarco, Eduardo Monguilhott; Dalmarco, Juliana Bastos; Lino, Manuel Rosa de Oliveira; Simionato, Edésio Luiz; Amara, Jorge Antônio; Frode, Tânia Sílvia; Filho, Danilo Wilhelm

doi:10.1590/s0066-782x2012005000015

Cited by 13 publications

(14 citation statements)

References 35 publications

(24 reference statements)

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“…Previously, a clinical benefit of this beta-blocker in association with enalapril and spironolactone was described in chronic chagasic patients inducing an increase in the left ventricle ejection fraction and a reduction in the circulating levels of the chemokine CCL5 and the brain natriuretic peptide [26]. Other clinical studies focused on the role of the carvedilol potentiating the antioxidative effect induced by C and E vitamins in chagasic individuals [40, 41]. Even considering the oxidative stress as part of the general inflammatory process, there a very few clinical and experimental studies involving carvedilol and mononuclear cells infiltration or the inflammatory mediators release during the T. cruzi infection.…”

Section: Discussionmentioning

confidence: 99%

Potential Role of Carvedilol in the Cardiac Immune Response Induced by Experimental Infection with Trypanosoma cruzi

Horta

Leite

Costa

et al. 2017

BioMed Research International

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Trypanosoma cruzi causes a cardiac infection characterized by an inflammatory imbalance that could become the inciting factor of the illness. To this end, we evaluated the role of carvedilol, a beta-blocker with potential immunomodulatory properties, on the immune response in C57BL/6 mice infected with VL-10 strain of T. cruzi in the acute phase. Animals (n = 40) were grouped: (i) not infected, (ii) infected, (iii) infected + carvedilol, and (iv) not infected + carvedilol. We analyzed parameters related to parasitemia, plasma levels of TNF, IL-10, and CCL2, and cardiac histopathology after the administration of carvedilol for 30 days. We did not observe differences in the maximum peaks of parasitemia in the day of their detection among the groups. The plasma TNF was elevated at 60 days of infection in mice treated or not with carvedilol. However, we observed a decreased CCL2 level and increased IL-10 levels in those infected animals treated with carvedilol, which impacted the reduction of the inflammatory infiltration in cardiac tissue. For this experimental model, carvedilol therapy was not able to alter the levels of circulating parasites but modulates the pattern of CCL2 and IL-10 mediators when the VL10 strain of T. cruzi was used in C57BL6 mice.

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Section: Discussionmentioning

confidence: 99%

Potential Role of Carvedilol in the Cardiac Immune Response Induced by Experimental Infection with Trypanosoma cruzi

Horta

Leite

Costa

et al. 2017

BioMed Research International

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“…Our group has also recently shown that the administration of carvedilol was effective in attenuating oxidative stress in the different stages of the disease, an effect that may be particularly important in CCHD 10 .…”

Section: Introductionmentioning

confidence: 85%

Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

Budni¹,

Pedrosa²,

Dalmarco³

et al. 2013

Arquivos Brasileiros De Cardiologia

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BackgroundChagas disease is still an important endemic disease in Brazil, and the cardiac involvement is its more severe manifestation. ObjectiveTo verify whether the concomitant use of carvedilol will enhance the antioxidant effect of vitamins E and C in reducing the systemic oxidative stress in chronic Chagas heart disease. MethodsA total of 42 patients with Chagas heart disease were studied. They were divided into four groups according to the modified Los Andes classification: 10 patients in group IA (normal electrocardiogram and echocardiogram; no cardiac involvement); 20 patients in group IB (normal electrocardiogram and abnormal echocardiogram; mild cardiac involvement); eight patients in group II (abnormal electrocardiogram and echocardiogram; no heart failure; moderate cardiac involvement); and four patients in group III (abnormal electrocardiogram and echocardiogram with heart failure; severe cardiac involvement). Blood levels of markers of oxidative stress were determined before and after a six-month period of treatment with carvedilol, and six months after combined therapy of carvedilol with vitamins E and C. The markers analyzed were as follows: activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase and reductase, myeloperoxidade and adenosine deaminase; and the levels of reduced glutathione, thiobarbituric-acid reactive substances, protein carbonyls, vitamin E, and nitric oxide. ResultsAfter treatment with carvedilol, all groups showed significant decrease in protein carbonyls and reduced glutathione levels, whereas nitric oxide levels and adenosine activity increased significantly only in the less severely affected group (IA). In addition, the activity of most of the antioxidant enzymes was decreased in the less severely affected groups (IA and IB). By combining the vitamins with carvedilol, a reduction in protein damage, in glutathione levels, and in the activity of most of the antioxidant enzymes were observed. ConclusionsThe decrease in oxidative stress levels observed by means of the markers tested was more significant when carvedilol was used in combination with the antioxidant vitamins. The findings suggest that both carvedilol alone and in combination with the vitamins were effective in attenuating the systemic oxidative stress in patients with Chagas heart disease, especially those less severely affected, thus suggesting the possibility of synergism between these compounds.

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“…In fact, in the Silva et al study [12], beta-blockers were not used. On the other hand, beta-blocker therapy has been found to have a beneficial effect experimentally and in patients with chronic Chagas' heart disease [13], [14], [15], [16], similarly to what happens in an experimental model of catecholamine cardiomyopathy [17]. In patients with chronic Chagas' heart disease, beta-blocker therapy parallels the beneficial effect observed in non-Chagas' disease patients regarding the appearance of malignant ventricular arrhythmias [18].…”

Section: Discussionmentioning

confidence: 84%

Clinical predictors of inducible sustained ventricular tachycardia during electrophysiologic study in patients with chronic Chagas' heart disease

Cardinalli-Neto

Lorga-Filho

Silva

et al. 2015

IJC Heart & Vasculature

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BackgroundClinical independent predictors of inducible sustained ventricular tachycardia (VT) during electrophysiologic study (EPS) are not known in patients with chronic Chagas' heart disease. The purpose of this investigation was to fill this gap.MethodsThe medical charts of 47 patients with a positive serology for Chagas' disease who had undergone EPS between September 2006 and July 2012 at our institution were reviewed. Reasons for the EPS were the presence of unexplained syncope, non-sustained ventricular tachycardia (NSVT) on either resting ECG or 24 h-Holter monitoring as well as a LVEF < 55% and > 35% at echocardiography. A stepwise logistic regression analysis was performed to identify noninvasive predictors of inducible sustained VT/ventricular fibrillation during EPS.ResultsOn univariate analysis, syncopal episodes (p = 0.04), amiodarone therapy (p < 0.005), diastolic blood pressure (p = 0.03), creatinine serum levels (p < 0.001), potassium serum levels (p < 0.001), and lengthening of the QRS complex (p = 0.03) were associated with inducible sustained VT during EPS. In the multivariate model, amiodarone therapy (p = 0.03; hazard ratio = 10; Wald coefficient = 4.5; 95% confidence interval 1.2 to 85.2) was the only variable retained as independent predictor of inducible sustained VT during EPS.ConclusionAmiodarone therapy was the only independent variable associated with sustained VT inducibility during EPS in patients with chronic Chagas' heart disease.

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Carvedilol atenua o estresse oxidativo na cardiopatia chagásica crônica

Abstract: Background: There is increasing evidence suggesting that Chagas disease involves oxidative damage and contributes to heart disease progression.

Cited by 13 publications

References 35 publications

Potential Role of Carvedilol in the Cardiac Immune Response Induced by Experimental Infection with Trypanosoma cruzi

Potential Role of Carvedilol in the Cardiac Immune Response Induced by Experimental Infection with Trypanosoma cruzi

Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

Clinical predictors of inducible sustained ventricular tachycardia during electrophysiologic study in patients with chronic Chagas' heart disease

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