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Title: Trypanosoma cruzi persistence in the native heart is associated with high-grade myocarditis, but not with Chagas' disease reactivation after heart transplantation
Citation: HISTOPATHOLOGY, v.61, suppl.1, Special Issue, p.36-37, 2012
Abstract: Introduction: Chagas’ disease is caused by the protozoan Trypanosoma cruzi. Around 20% of infected people develop a chronic, inflammatory cardiomyopathy which may progress to end-stage heart failure. Chagas’ disease reactivation (CDR) may occur after heart transplantation (HT), usually in the first year of follow-up. CDR is a life-threatening complication characterized by relapse of the disease with direct detection of T. cruzi parasites in blood or tissues. We investigated if high-grade myocarditis and/or detection of T. cruzi parasites in the native heart are associated with CDR after HT. Material and Methods: The native heart of 16 chagasic patients who presented CDR after HT (CDR+ group) were compared to the native heart of 11 chagasic patients who never presented CDR in a follow-up of at least 18 months after HT (CDR – group). The intensity of myocarditis was evaluated semi-quantitatively. Parasite persistence was investigated through immunohistochemistry for T. cruzi antigens and qualitative polymerase chain reaction (PCR) for T. cruzi kDNA. Fisher exact test was used to compare data. Results: High-grade myocarditis was present in 15/16 (93.8%) samples of CDR+ group and 9/11 (81.8%) samples of CDR – group (P = 0.549). Parasite persistence, mainly detected through the PCR-based assay, occurred in 13/16 (81.3%) samples of CDR+ group and 7/11 (63.6%) samples of CDR – group (P = 0.391). High-grade myocarditis was present in 20/20 (100%) samples presenting parasite persistence and 4/7 (57.1%) samples without parasite persistence (P = 0.012). Conclusion: Although parasite persistence is associated with high-grade myocarditis in the native heart, neither of them is associated with CDR after HT.
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Comunicações em Eventos - HC/InCor
Instituto do Coração - HC/InCor

Comunicações em Eventos - LIM/11
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação

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