Troponin in Chagas disease

Arias, Roque; Bastos, Claudilson; Mota, Gildo; Sodré, Fábio L.; Moreira, Ana Catarina; Tavares, Armando Dias; Lima, Jailson Costa

doi:10.1590/s1413-86702003000600001

Cited by 15 publications

(17 citation statements)

References 3 publications

(3 reference statements)

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“…Regarding the use of comparison groups, it was observed that in 18 articles (58%) the authors used the design of comparisons between groups 8,13-18,21,24,26,27,31,35,37,33,40-41,43 . It is also interesting to note the predominance of adult patients in the selected studies, with only one study including adolescent chagasic patients 23 .…”

Section: Resultsmentioning

confidence: 99%

“…As for the addressed topics, 10 articles considered prognostic factors of mortality and risk of disease progression using echocardiography 13,19,22,23,26,28,30,32,35,36 , five studies assessed left ventricular ejection fraction (LVEF) 20,25,29,34,39 , alone or together with prognostic factors, seven articles assessed systolic and diastolic ventricular function with tissue Doppler 15-17,27,33,36,40 , five assessed concentrations of brain natriuretic peptide (BNP) 21,24,29,31,37 , one study assessed the prognostic value of troponin concentrations 18 , one study evaluated ventricular dyssynchrony 38 , two studies assessed cardiac dysautonomia 14,41 , two studies used two-dimensional echocardiography to assess ventricular deformation (strain, strain rate and twisting) 33,42 and one study addressed the proinflammatory and prothrombotic factors in Chagas disease 43 .…”

Section: Resultsmentioning

confidence: 99%

“…Studies with group comparison 13-18,21,24,26,27,31,33,35,37,40,41 aimed to evaluate the clinical, hemodynamic and evolution aspects of Chagas cardiomyopathy, while those aimed to identifying morphological and functional characteristics related to prognosis and mortality did not employ this methodology 19,20,22,23,25,28-30,32,34,36,38,39 . The identification of the predominance of publications aimed to investigate adult patients (between the third and fourth decades of life), when compared to those involving adolescents, seems justified by the physiopathology of the disease.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and Echocardiographic Predictors of Mortality in Chagasic Cardiomyopathy - Systematic Review

Júnior¹,

Filho²

2014

Arquivos Brasileiros De Cardiologia

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Diagnosis, prognosis and evaluation of death risk in Chagas cardiomyopathy still constitute a challenge due to the diversity of manifestations, which determine the importance of using echocardiography, tissue Doppler and biomarkers. To evaluate, within a systematic review, clinical and echocardiographic profiles of patients with chronic chagasic cardiomyopathy, which may be related to worse prognosis and major mortality risk. To perform the systematic review, we used Medline (via PubMed), LILACS and SciELO databases to identify 82 articles published from 1991 to 2012, with the following descriptors: echocardiography, mortality and Chagas disease. We selected 31 original articles, involving diagnostic and prognostic methods. The importance of Chagas disease has increased due to its emergence in Europe and United States, but most evidence came from Brazil. Among the predictors of worse prognosis and higher mortality risk are morphological and functional alterations in the left and right ventricles, evaluated by conventional echocardiography and tissue Doppler, as well as the increase in brain natriuretic peptide and troponin I concentrations. Recently, the evaluations of dyssynchrony, dysautonomia, as well as strain, strain rate and myocardial twisting were added to the diagnostic arsenal for the early differentiation of Chagas cardiomyopathy. Developments in imaging and biochemical diagnostic procedures have enabled more detailed cardiac evaluations, which demonstrate the early involvement of both ventricles, allowing a more accurate assessment of the mortality risk in Chagas disease.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical and Echocardiographic Predictors of Mortality in Chagasic Cardiomyopathy - Systematic Review

Júnior¹,

Filho²

2014

Arquivos Brasileiros De Cardiologia

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“…Persistent MDE from repeated MRI studies accompanied by chronic elevation of biomarkers (18,19), myocardial perfusion abnormalities by scintigraphy, and normal coronary arteries by angiography (20) reflect the effect of continued myocyte loss with relentless replacement by MF as defined by previous pathological studies (6,17).…”

Section: Discussionmentioning

confidence: 99%

Myocardial Delayed Enhancement by Magnetic Resonance Imaging in Patients With Chagas’ Disease

Rochitte

Oliveira

Andrade

et al. 2005

Journal of the American College of Cardiology

279

204

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“…With respect to the inflammation background in chronic Chagas' disease, especially that derived from focal inflammation spots and microlesions found in the chagasic heart, we suggest that chronic Chagas' patients with heart disease could present with increased levels of cardiac troponin in their blood. However, there have only been two previous studies and a single patient observation that analyzed cardiac troponin levels in Chagas' heart disease [169][170][171]. These studies did not indicate a profound relationship between Chagas' heart disease and cardiac troponin release, probably because of the insufficient sensitivity of the assays (below or near the 99th percentile of the reference population).…”

Section: Early Diagnosis and Monitoring Of Chagas' Heart Diseasementioning

confidence: 99%

Chronic Chagas’ heart disease: a disease on its way to becoming a worldwide health problem: epidemiology, etiopathology, treatment, pathogenesis and laboratory medicine

et al. 2010

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Chagas' disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America. Nearly 30% of infected patients develop life-threatening complications, and with a latency of 10-30 years, mostly Chagas' heart disease which is currently the major cause of morbidity and mortality in Latin America, enormously burdening economic resources and dramatically affecting patients' social and labor situations. Because of increasing migration, international tourism and parasite transfer by blood contact, intrauterine transfer and organ transplantation, Chagas' heart disease could potentially become a worldwide problem. To raise awareness of this problem, we reflect on the epidemiology and etiopathology of Chagas' disease, particularly Chagas' heart disease. To counteract Chagas' heart disease, in addition to the general interruption of the infection cycle and chemotherapeutic elimination of the infection agent, early and effective causal or symptomatic therapies would be indispensable. Prerequisites for this are improved knowledge of the pathogenesis and optimized patient management. From economic and logistics viewpoints, this last prerequisite should be performed using laboratory medicine tools. Consequently, we first summarize the mechanisms that have been suggested as driving Chagas' heart disease, mainly those associated with the presence of autoantibodies against G-protein-coupled receptors; secondly, we indicate new treatment strategies involving autoantibody apheresis and in vivo autoantibody neutralization; thirdly, we present laboratory medicine tools such as autoantibody estimation and heart marker measurement, proposed for diagnosis, risk assessment and patient guidance and lastly, we critically reflect upon the increase in inflammation and oxidative stress markers in Chagas' heart disease.

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Troponin in Chagas disease

Cited by 15 publications

References 3 publications

Clinical and Echocardiographic Predictors of Mortality in Chagasic Cardiomyopathy - Systematic Review

Clinical and Echocardiographic Predictors of Mortality in Chagasic Cardiomyopathy - Systematic Review

Myocardial Delayed Enhancement by Magnetic Resonance Imaging in Patients With Chagas’ Disease

Chronic Chagas’ heart disease: a disease on its way to becoming a worldwide health problem: epidemiology, etiopathology, treatment, pathogenesis and laboratory medicine

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