Assessment of biomarkers and clinical parameters as predictors of survival in patients with chagasic heart failure
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article
Data de publicação
2023
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PUBLIC LIBRARY SCIENCE
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PLOS NEGLECTED TROPICAL DISEASES, v.17, n.12, article ID e0011847, 12p, 2023
Resumo
Background Chagas disease, endemic in Latin America and spreading globally due to emigration, has a significant health burden, particularly in relation to chagasic heart failure (HF). Chagasic cardiomyopathy (CCM) is characterized by chronic inflammatory myocardial disease. This study aimed to identify inflammatory parameters and biomarkers that could aid in the management of patients with chagasic HF. Methods and findings A cohort study was conducted at a tertiary cardiology single-center over a mean follow-up period of 2.4 years. The study included patients with HF secondary to CCM enrolled between October 2013 and July 2017. Various clinical parameters, echocardiography findings, parasitemia status, brain natriuretic peptide (BNP) and troponin T (TnT) levels, and inflammatory biomarkers (IL-6, IL-10, IL-12p70, IL-17A, adiponectin, and IFN-gamma) were assessed. The study encompassed a cohort of 103 patients, with a median age of 53 years and 70% being male. The left ventricular ejection fraction (LVEF) was 28%, with 40% of patients classified as NYHA II functional class. The median BNP level was 291 pg/ml. The observed mortality rate during the study period was 38.8%. Predictors of lower survival were identified as elevated levels of BNP, TnT, reduced LVEF, and increased adiponectin (thresholds: BNP > 309 pg/ml, TnT > 27.5 ng/ml, LVEF < 25.5%, adiponectin > 38 mu g/mL). Notably, there was no evidence indicating a relationship between parasitemia and the inflammatory parameters with lower survival in these patients, including INF-gamma, IL-6, IL-10, IL12-(p70), and IL17a. Conclusion Despite the presence of a chronic inflammatory process, the evaluated inflammatory biomarkers in this cohort were not predictive of survival in patients with chagasic HF with reduced ejection fraction (HFrEF). However, reduced LVEF, elevated BNP, adiponectin levels, and troponin T were identified as predictors of lower survival in these patients.
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Referências
- Ahmad T, 2012, NAT REV CARDIOL, V9, P347, DOI 10.1038/nrcardio.2012.37
- [Anonymous], 2015, Wkly Epidemiol Rec, V90, P33
- Barbosa-Ferreira JM, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0131447
- Benvenuti LA, 2008, ANN TROP MED PARASIT, V102, P481, DOI 10.1179/136485908X311740
- Benziger CP, 2017, CARDIOL CLIN, V35, P31, DOI 10.1016/j.ccl.2016.08.013
- Bocchi EA, 2013, J AM COLL CARDIOL, V62, P949, DOI 10.1016/j.jacc.2013.06.013
- Bosch-Nicolau P, 2022, FRONT CARDIOVASC MED, V8, DOI 10.3389/fcvm.2021.787214
- Tobar IB, 2011, REV SOC BRAS MED TRO, V44, P691, DOI 10.1590/S0037-86822011000600008
- Celik T, 2010, INT J CARDIOL, V144, P319, DOI 10.1016/j.ijcard.2009.03.006
- D'Avila DA, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0208133
- Echeverría LE, 2021, PLOS ONE, V16, DOI 10.1371/journal.pone.0258622
- Hasslocher-Moreno AM, 2021, ECLINICALMEDICINE, V31, DOI 10.1016/j.eclinm.2020.100694
- Horwich TB, 2003, CIRCULATION, V108, P833, DOI 10.1161/01.CIR.0000084543.79097.34
- de Souza ACJ, 2015, INT J CARDIOL, V187, P700, DOI 10.1016/j.ijcard.2015.03.372
- Kociol RD, 2010, J AM COLL CARDIOL, V56, P1071, DOI 10.1016/j.jacc.2010.06.016
- Lima-Costa MF, 2010, AM J EPIDEMIOL, V172, P190, DOI 10.1093/aje/kwq106
- LIMAS CJ, 1995, CIRCULATION, V91, P631, DOI 10.1161/01.CIR.91.3.631
- López L, 2006, REV ESP CARDIOL, V59, P50, DOI 10.1157/13083649
- Magalhaes LMD, 2022, LANCET MICROBE, V3, pE711, DOI 10.1016/S2666-5247(21)00265-2
- Maldonado E, 2021, OXID MED CELL LONGEV, V2021, DOI 10.1155/2021/4993452
- Marin-Neto JA, 2022, PREPRINT, DOI [10.1590/SciELOPreprints.4820, DOI 10.1590/SCIELOPREPRINTS.4820]
- Morillo CA, 2015, NEW ENGL J MED, V373, P1295, DOI 10.1056/NEJMoa1507574
- Murphy SP, 2020, J AM COLL CARDIOL, V75, P1324, DOI 10.1016/j.jacc.2020.01.014
- O'Connor CM, 2011, NEW ENGL J MED, V365, P32, DOI 10.1056/NEJMoa1100171
- Nunes MCP, 2018, CIRCULATION, V138, pE169, DOI 10.1161/CIR.0000000000000599
- Pfisterer M, 2009, JAMA-J AM MED ASSOC, V301, P383, DOI 10.1001/jama.2009.2
- Poveda C, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0091154
- Rassi A, 2006, NEW ENGL J MED, V355, P799, DOI 10.1056/NEJMoa053241
- Rauchhaus M, 2000, CIRCULATION, V102, P3060
- Sabino EC, 2015, EUR J HEART FAIL, V17, P416, DOI 10.1002/ejhf.220
- Saravia SGM, 2013, CLIN BIOCHEM, V46, P1615, DOI 10.1016/j.clinbiochem.2013.06.011
- Saunders JT, 2011, CIRCULATION, V123, P1367, DOI 10.1161/CIRCULATIONAHA.110.005264
- Shen L, 2017, CIRC-HEART FAIL, V10, DOI 10.1161/CIRCHEARTFAILURE.117.004361
- Sherbuk JE, 2015, GLOB HEART, V10, P173, DOI 10.1016/j.gheart.2015.07.003
- Sousa GR, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0172833
- Sousa GR, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0087082
- Tanowitz HB., 2016, Trypanosoma cruzi and Chagas disease: innate immunity, ROS, and cardiovascular system, P183
- de Freitas VLT, 2011, PLOS NEGLECT TROP D, V5, DOI 10.1371/journal.pntd.0001277
- Tsukamoto O, 2009, J AM COLL CARDIOL, V53, P2070, DOI 10.1016/j.jacc.2009.02.038
- Van Berendoncks An M, 2011, Curr Heart Fail Rep, V8, P113, DOI 10.1007/s11897-011-0056-6
- Van Tassell BW, 2013, CIRCULATION, V128, P1910, DOI 10.1161/CIRCULATIONAHA.113.003199
- Viotti R, 2006, ANN INTERN MED, V144, P724, DOI 10.7326/0003-4819-144-10-200605160-00006