Types of arrhythmia among cases of American trypanosomiasis, compared with those in other cardiology patients

Abstract

The frequencies of each type of arrythmia were investigated, by age and sex, among 3056 Brazilian patients with cardiac arrhythmia. Each patient investigated had been tested serologically for American trypanosomiasis and 1013 had been found seropositive for the disease. In general, the seropositive 'chagasic' patients were each likely to be suffering from more types of arrhythmia than the seronegative 'non-chagasic', with means of 1.81 and 1.03 types/patient, respectively. Right-branch bundle blocks (RBBB), ventricular extrasystoles (VE) and left anterior hemiblocks (LAHB) were the commonest cardiac arrhythmias among the chagasic patients, and each of these types of arrhythmia (alone or with other types of arrythmia) was more frequent in the chagasic patients than the non-chagasic. The incidence of RBBB among the arrhythmic varied significantly with age in the non-chagasic patients (increasing with age among both the males and females) but not among the chagasic subjects. When the frequencies of each type of arrythmia and each combination of types were compared, the co-occurrence of RBBB and another type of arrhythmia was almost indicative of American trypanosomiasis (occurring in 30.6% of the chagasic subjects but only 2.6% of the non-chagasic). Similarly, only 0.4% of the non-chagasic patients but 7.4% of the chagasic had RBBB, VE and LAHB concurrently. However, the frequencies of RBBB in isolation (i.e. with no other, concurrent, electrocardiographic abnormality), VE in isolation, or LAHB in isolation were not significantly different in the chagasic and non-chagasic patients.

Myocardial Gene Expression ofT-bet,GATA-3,Ror-γt,FoxP3, and Hallmark Cytokines in Chronic Chagas Disease Cardiomyopathy: An Essentially Unopposed TH1-Type Response

“…However, since both FoxP3 and CTLA-4 can be transiently expressed in activated human T cells, we cannot formally exclude that the increased expression was merely due to the presence of activated T cells belonging to other functional subsets [40, 41]. Our findings of lack of upregulation of TGF - β in situ are in apparent contrast with the immunohistochemical study by Araúijo-Jorge et al [33] who have identified a low number of TGF- β + mononuclear cells infiltrating CCC myocardium. However, that report failed to show values from healthy control tissue samples, so it is not possible to assess whether the detected values were above baseline.…”

“…All Chagas disease and NIC patients underwent standard electrocardiography and 2-dimension and M-mode echocardiography in the hospital setting as described [18]. Patients with CCC presented with typical electrocardiographic findings such as right bundle branch block and/or left anterior division hemiblock [33], in addition to ventricular dysfunction classified on the basis of left ventricular ejection fraction <40%. Myocardial left ventricular free wall heart samples were obtained from end-stage heart failure CCC patients (Table 1) and end-stage heart failure patients with noninflammatory cardiomyopathies (NIC, five patients with idiopathic dilated cardiomyopathy and three patients with ischemic cardiomyopathy, all seronegative for T. cruzi; Table 1).…”

Myocardial Chemokine Expression and Intensity of Myocarditis in Chagas Cardiomyopathy Are Controlled by Polymorphisms in CXCL9 and CXCL10

“…The left ventricular dimensions and regional and global function evaluations were performed using a 2-dimension and M-mode approach, in accordance with the recommendations of the American Society of Echocardiography. Patients with CCC presented with abnormal electrocardiography findings that ranged from typical conduction abnormalities (right bundle branch block and/or left anterior division hemiblock) to severe arrhythmia [32]. A group of patients also presented varying degrees of ventricular dysfunction classified on the basis of left ventricular ejection fraction, with all other causes of ventricular dysfunction/heart failure excluded.…”

Genetic susceptibility to Chagas disease cardiomyopathy: involvement of several genes of the innate immunity and chemokine-dependent migration pathways

“…ASY subjects had no electrocardiography and echocardiography changes. CCC patients presented typical conduction abnormalities (right bundle branch block and/or left anterior division hemiblock) [56]. CCC patients with significant left ventricular systolic dysfunction (LVEF <40%) were classified as having severe CCC, whereas those with no significant ventricular dysfunction (LVEF ≥40%) were classified as having moderate CCC.…”