Prevalence of Trypanosoma cruzi antibodies and inflammatory markers in uncompensated heart failure
Prevalence of Trypanosoma cruzi antibodies and inflammatory markers in uncompensated heart failure
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DOI：
10.1590/s0037-86822011000600008
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发表时间：
2011-12-01
影响因子：
2
通讯作者：
Bonfante-Cabarcas, Rafael
中科院分区：
文献类型：
--
作者：
Tobar, Iván Bravo;Parra, Freddy;Bonfante-Cabarcas, Rafael
简介：心力衰竭（HF）是慢性肝炎性心肌病（CChC）的最后阶段。CChC的诊断基于抗克氏锥虫抗体（aTcAg）以及临床和流行病学数据的证明。在委内瑞拉，没有关于Chagglutinin HF患病率的数据。本研究的目的是确定与血清阴性或血清阳性HF患者相关的流行病学、临床和炎症危险因素。研究方法：我们在委内瑞拉中西部各州的健康农村人群和因失代偿性心力衰竭而被急诊室收治的患者中进行了一项横断面研究。结果：健康人群和心力衰竭患者血清克氏锥虫抗体阳性率分别为11.2%和40.1%。健康个体中的血清阳性与年龄、对锥蝽媒介的了解以及在家中见过野生水库有关; HF患者中，与媒介的接触以及先前的恰加斯病临床诊断有关;在两组中，与年龄、对锥蝽媒介的了解以及HF有关。血清阳性患者QRS延长，射血分数降低，血清镁升高，与HF血清阴性患者相比均具有显著性。左心房扩大和心室肥大最常见于HF血清阴性患者。CRP、IL 6、IL β 1、IL 2和FNT α分别在94.5%、48%、17.8%、13.7%和6.9%的HF患者中升高，但只有IL 2水平与慢性心力衰竭相关。结论：在委内瑞拉中西部地区的HF患者中，aTcAg的患病率很高，与血清阴性病例相比，其流行病学、临床和炎症特征有明显不同。
Introduction: Heart failure (HF) represents the final stage of chronic chagasic cardiomyopathy (CChC). The diagnosis of CChC is based on the demonstration of anti-Trypanosoma cruzi antibodies (aTcAg) and clinical and epidemiological data. In Venezuela, there are no data about the prevalence of chagasic HF. The aim of this study was to determine the epidemiological, clinical, and inflammatory risk factors associated with seronegative or seropositive HF patients. Methods: We performed a cross-sectional study in the Venezuelan central-west states among a healthy rural population and in patients admitted to the emergency room with uncompensated HF. Results: The seroprevalence rates of Trypanosoma cruzi antibodies were 11.2% and 40.1% in the healthy population and in HF patients, respectively. Seropositivity in healthy individuals was associated with age, knowledge on triatomine vectors, and having seen wild reservoirs in the house; in HF patients, with contact with the vector and previous clinical diagnosis of Chagas' disease; and in both groups taken together, with age, knowledge on triatomines, and HF. Seropositive patients had prolonged QRS, decreased ejection fraction, and high serum magnesium, all significant as compared with HF seronegative cases. Left atrium enlargement and ventricular hypertrophy were most frequently observed in HF seronegative patients. CRP, IL6, IL beta 1, IL2, and FNT alpha were elevated in 94.5%, 48%, 17.8%, 13.7%, and 6.9% of HF patients, respectively, but only IL2 levels were associated with chagasic HF. Conclusions: There is a high prevalence of aTcAg in HF patients from the central-west region of Venezuela, and their epidemiological, clinical, and inflammatory features are discreetly different as compared with those of seronegative cases.