The course of patients with Chagas heart disease during episodes of decompensated heart failure

Issa, Victor Sarli; Ayub‐Ferreira, Silvia Moreira; Schroyens, Matthew; Chizzola, Paulo Roberto; Soares, Paulo Rogério; Lage, Silvia Helena Gelas; Bocchi, Edimar Alcides

doi:10.1002/ehf2.13232

Cited by 11 publications

(5 citation statements)

References 33 publications

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“…In addition, Chagas disease patients were more frequently in need of inotropic support or intra-aortic balloon pump, and had larger hearts than non-Chagas disease patients. Moreover, prognosis at 6 months were poorer in Chagas disease than in non-Chagas disease patients ( 40 ).…”

Section: Cardiovascular Diseases Managementmentioning

confidence: 99%

Management of Cardiovascular Disease in Patients With COVID-19 and Chronic Chagas Disease: Implications to Prevent a Scourge Still Larger

Bestetti

Bocchi²,

Bestetti³

et al. 2022

Front. Med.

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Cardiovascular diseases (CVD) are the most important cause of morbidity and mortality in the general population. Because the high prevalence of COVID-19 and chronic Chagas disease (CCD) where the latter is endemic, all such diseases will likely be observed in the same patient. While COVID-19 can provoke generalized endotheliitis, which can lead to a cytokine storm and a hyper-coagulable state culminating into in-site and at a distance thrombosis. Therefore, small-vessel coronary artery disease (CAD), cerebrovascular disease, thromboembolism, and arrhythmias are prominent findings in COVID-19. In CCD, small-vessel CAD, cardioembolic stroke, pulmonary embolism, heart failure and arrhythmias are frequently observed as a result of a similar but less intense mechanism. Consequently, the association of CCD and COVID-19 will likely increase the incidence of CVD. Thus, doctors on the frontline should be on the alert for this diagnostic possibility so that the proper treatment can be given without any delay.

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Section: Cardiovascular Diseases Managementmentioning

confidence: 99%

Management of Cardiovascular Disease in Patients With COVID-19 and Chronic Chagas Disease: Implications to Prevent a Scourge Still Larger

Bestetti

Bocchi²,

Bestetti³

et al. 2022

Front. Med.

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“…Another relevant finding presented here was the association between LVDF parameters with age, with TAPSE and MAPSE values not being influenced by age. The prevalence of LV diastolic dysfunction increases with age, especially in hypertensive women, [26][27][28] indicating progressive LV relaxation worsening. However, no study has consistently correlated TAPSE and MAPSE values with advancing age.…”

Section: Original Articlementioning

confidence: 99%

“…25,26 More recent studies associated RV systolic dysfunction with a worse prognosis in patients with heart failure due to Chagas disease, who are at a higher risk of death and require urgent heart transplantation. 27 Thus, it is essential to examine the RV of patients with Chagas disease during clinical follow-up. However, the peculiar characteristics of this chamber, particularly its thin walls and complex geometry, may be obstacles to its analysis.…”

Section: Right Ventricle In Chagas Diseasementioning

confidence: 99%

Untitled

2022

Arq Bras Cardiol: Imagem Cardiovasc

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My approach to Cirino et al. Echocardiographic Diagnosis of And Follow-up for Muscular Dystrophiesliterature is scarce on the use of new echocardiographic techniques such as myocardial strain in EDMD. Due to the high risk of conduction disorders, ventricular arrhythmias, and sudden cardiac death associated with EDMD, cardiac screening of first-degree relatives and asymptomatic carriers should be performed routinely. For the same reason, an implantable cardioverter-defibrillator should be considered for primary prevention in EDMD type 2. 17

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“…Available therapies are insufficient and do not fully address molecular abnormalities that occur in cardiomyocytes ( 1 ). Chagas disease cardiomyopathy (CCC) accounts for 25% of HF cases and is a major cause of death in Latin America ( 2 , 3 ). CCC is a severe inflammatory dilated cardiomyopathy caused by persistent infection by the protozoan Trypanosoma cruzi.…”

Section: Introductionmentioning

confidence: 99%

Co-Exposure of Cardiomyocytes to IFN-γ and TNF-α Induces Mitochondrial Dysfunction and Nitro-Oxidative Stress: Implications for the Pathogenesis of Chronic Chagas Disease Cardiomyopathy

et al. 2021

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Infection by the protozoan Trypanosoma cruzi causes Chagas disease cardiomyopathy (CCC) and can lead to arrhythmia, heart failure and death. Chagas disease affects 8 million people worldwide, and chronic production of the cytokines IFN-γ and TNF-α by T cells together with mitochondrial dysfunction are important players for the poor prognosis of the disease. Mitochondria occupy 40% of the cardiomyocytes volume and produce 95% of cellular ATP that sustain the life-long cycles of heart contraction. As IFN-γ and TNF-α have been described to affect mitochondrial function, we hypothesized that IFN-γ and TNF-α are involved in the myocardial mitochondrial dysfunction observed in CCC patients. In this study, we quantified markers of mitochondrial dysfunction and nitro-oxidative stress in CCC heart tissue and in IFN-γ/TNF-α-stimulated AC-16 human cardiomyocytes. We found that CCC myocardium displayed increased levels of nitro-oxidative stress and reduced mitochondrial DNA as compared with myocardial tissue from patients with dilated cardiomyopathy (DCM). IFN-γ/TNF-α treatment of AC-16 cardiomyocytes induced increased nitro-oxidative stress and decreased the mitochondrial membrane potential (ΔΨm). We found that the STAT1/NF-κB/NOS2 axis is involved in the IFN-γ/TNF-α-induced decrease of ΔΨm in AC-16 cardiomyocytes. Furthermore, treatment with mitochondria-sparing agonists of AMPK, NRF2 and SIRT1 rescues ΔΨm in IFN-γ/TNF-α-stimulated cells. Proteomic and gene expression analyses revealed that IFN-γ/TNF-α-treated cells corroborate mitochondrial dysfunction, transmembrane potential of mitochondria, altered fatty acid metabolism and cardiac necrosis/cell death. Functional assays conducted on Seahorse respirometer showed that cytokine-stimulated cells display decreased glycolytic and mitochondrial ATP production, dependency of fatty acid oxidation as well as increased proton leak and non-mitochondrial oxygen consumption. Together, our results suggest that IFN-γ and TNF-α cause direct damage to cardiomyocytes’ mitochondria by promoting oxidative and nitrosative stress and impairing energy production pathways. We hypothesize that treatment with agonists of AMPK, NRF2 and SIRT1 might be an approach to ameliorate the progression of Chagas disease cardiomyopathy.

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The course of patients with Chagas heart disease during episodes of decompensated heart failure

Cited by 11 publications

References 33 publications

Management of Cardiovascular Disease in Patients With COVID-19 and Chronic Chagas Disease: Implications to Prevent a Scourge Still Larger

Management of Cardiovascular Disease in Patients With COVID-19 and Chronic Chagas Disease: Implications to Prevent a Scourge Still Larger

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Co-Exposure of Cardiomyocytes to IFN-γ and TNF-α Induces Mitochondrial Dysfunction and Nitro-Oxidative Stress: Implications for the Pathogenesis of Chronic Chagas Disease Cardiomyopathy

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