La mejoría electrocardiográfica con el tratamiento de la enfermedad de Chagas crónica, es independiente de la persistencia de Trypanosoma cruzi

Abstract

Background: At the present time the assessment of results of treatment of Chagas disease is mainly parasitological. Anti Trypanosoma cruzi (Rev Méd Chile 2005; 133: 1153-60).

Association Between Trypanosoma cruzi DNA in Peripheral Blood and Chronic Chagasic Cardiomyopathy: A Systematic Review

“…Finally, we included 12 studies comprising 1,686 patients (12,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45), which are described in Table 1. Eight studies were cross-sectional studies, 3 were designed as prospective cohorts, and 1 was a case-control study.…”

“…All studies used a single venous blood sample for PCR determination. Six studies (50%) used a conventional PCR method (35)(36)(37)(38)(39)41) while the other half used real-time PCR method (12,40,(42)(43)(44)(45). Only four studies used a quantitative method to report PCR results (12,(40)(41)(42) while the rest of the studies used a qualitative method.…”

“…None of the non-endemic studies identified an association between parasite DNA detection in peripheral blood and CCC. Six studies reported greater positive PCR ratios among patients with CCC than in patients with ICD although differences did not achieve statistical significance (36,37,41,42,44,45). The remaining 4 studies reported a positive PCR rate that favored patients with ICD (38)(39)(40)43).…”

“…In 4 (33.3%) studies, ECG was combined with echocardiography, in 1 (8%) was combined with chest radiography, and in 4 (33.3%), the 3 ancillary tests were performed. CCC classification was very heterogeneous and included either predefined criteria by the authors ( 35 – 37 , 40 , 43 ) or standardized classifications as Minnesota criteria ( 12 , 38 ), Kuschnir criteria ( 39 , 44 , 45 ), Rocha criteria ( 42 ), and New York Heart Association (NYHA) classification ( 41 ). Among the included patients, 998 (59.2%) were classified as ICD and 688 (40.8%) as CCC.…”

“…Regarding outcome measurement (PCR), all the studies specified their protocol and almost all included control samples and maintained the same procedure in all samples. As per CCC assessment, six studies were rated at low risk of bias since they included blind ECG assessment and/or double assessment by different investigators ( 12 , 37 , 38 , 40 , 41 , 45 ). Conversely, two studies that neither used a standardized classification nor reported their ECG or echocardiographic findings were considered at high risk of bias ( 35 , 43 ).…”