Clinical course of Chagas' heart disease: a comparison with dilated cardiomyopathy

Bestetti, Reinaldo B.; Muccillo, Gerson

doi:10.1016/s0167-5273(97)00083-1

Cited by 172 publications

(132 citation statements)

References 28 publications

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“…In fact, it is the leading cause of chronic heart failure in areas where the disease is endemic 3 , its prognosis is worse than that observed in non-Chagas' disease heart failure 3,4 and affects about 4% to 8% of outpatients living in rural areas and up to 76% of patients followed at a tertiary referral center 5 . Digoxin is an integral component of the pharmacological armamentarium for the treatment of chronic systolic heart failure secondary to Chagas' cardiomyopathy, particularly for patients in New York Heart Association Class III or IV 5 .…”

Section: Palavrasmentioning

confidence: 99%

Digoxin serum levels in patients with Chagas' cardiomyopathy and heart failure

Ferrari

Bestetti

Cardinalli-Neto

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction: The purpose of this study was to determine digoxin serum concentrations in patients with Chagas' cardiomyopathy with chronic heart failure, because little is known concerning this laboratory test in patients with this condition. Methods: This study focuses on 29 (29%) out of 101 patients with chronic heart failure secondary to Chagas' cardiomyopathy receiving digoxin therapy. Digoxin was measured by the immune-enzymatic method. Results: New York Heart Association Functional Class III/IV was noted in 13 (45%) patients. The mean potassium serum level was 4.3± 0.5mEq/L, mean creatinine serum levels 1.4± 0.3dg/100ml, and left ventricular ejection fraction 34.7± 13.8%. The median digoxin serum level was 1.27 (0.55; 1.79)ng/ml. Sixteen (55%) patients had digoxin serum levels higher than 1.0ng/ml. Abnormal digoxin serum levels were verified in 13 (45%) patients. Digoxin serum levels correlated moderately with creatinine serum levels (r = 0.39; p≤ 0.03) and negatively with sodium serum levels (r= -0.38; p= 0.03). Conclusions: Digoxin serum concentration should be measured in patients with Chagas' cardiomyopathy with chronic heart failure receiving digoxin therapy due to the potential for digoxin toxicity.

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Section: Palavrasmentioning

confidence: 99%

Digoxin serum levels in patients with Chagas' cardiomyopathy and heart failure

Ferrari

Bestetti

Cardinalli-Neto

et al. 2010

Rev. Soc. Bras. Med. Trop.

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“…The heart failure clinical setting is more serious and present a poor prognosis, especially in the context of Chagas' patients [3,4]. Pulmonary hypertension has been often associated with pulmonary and left ventricular dysfunction in approximately 35% of the cases.…”

Section: Introductionmentioning

confidence: 99%

Pressão pulmonar aferida pela ecocardiografia em pacientes chagásicos indicados para transplante cardíaco

Gelape¹,

C²,

Braulio³

et al. 2011

Rev Bras Cir Cardiovasc

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“…In spite of the recent advances in vector control, the millions of patients already infected deserve more attention from the scientific community. Furthermore, clinical progression, length of survival and overall prognosis are significantly worse in CCC patients compared with patients with dilated cardiomyopathy of non-inflammatory etiology (2,3).…”

Section: Introductionmentioning

confidence: 99%

Proteomic inventory of myocardial proteins from patients with chronic Chagas' cardiomyopathy

Teixeira¹,

Iwai²,

Kuramoto³

et al. 2006

Braz J Med Biol Res

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Chronic Chagas' disease cardiomyopathy (CCC) is an often fatal outcome of Trypanosoma cruzi infection, with a poorer prognosis than other cardiomyopathies. CCC is refractory to heart failure treatments, and is the major indication of heart transplantation in Latin America. A diffuse myocarditis, plus intense myocardial hypertrophy, damage and fibrosis, in the presence of very few T. cruzi forms, are the histopathological hallmarks of CCC. To gain a better understanding of the pathophysiology of CCC, we analyzed the protein profile in the affected CCC myocardium. Homogenates from left ventricular myocardial samples of end-stage CCC hearts explanted during heart transplantation were subjected to two-dimensional electrophoresis with Coomassie blue staining; protein identification was performed by MALDI-ToF mass spectrometry and peptide mass fingerprinting. The identification of selected proteins was confirmed by immunoblotting. We demonstrated that 246 proteins matched in gels from two CCC patients. They corresponded to 112 distinct proteins. Along with structural/contractile and metabolism proteins, we also identified proteins involved in apoptosis (caspase 8, caspase 2), immune system (T cell receptor ß chain, granzyme A, HLA class I) and stress processes (heat shock proteins, superoxide dismutases, and other oxidative stress proteins). Proteins involved in cell signaling and transcriptional factors were also identified. The identification of caspases and oxidative stress proteins suggests the occurrence of active apoptosis and significant oxidative stress in CCC myocardium. These results generated an inventory of myocardial proteins in CCC that should contribute to the generation of hypothesis-driven experiments designed on the basis of the classes of proteins identified here.

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Clinical course of Chagas' heart disease: a comparison with dilated cardiomyopathy

Cited by 172 publications

References 28 publications

Digoxin serum levels in patients with Chagas' cardiomyopathy and heart failure

Digoxin serum levels in patients with Chagas' cardiomyopathy and heart failure

Pressão pulmonar aferida pela ecocardiografia em pacientes chagásicos indicados para transplante cardíaco

Proteomic inventory of myocardial proteins from patients with chronic Chagas' cardiomyopathy

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