Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy
BACKGROUND Serum brain-derived neurotrophic factor (BDNF) levels have been shown to be lower in patients with Chagas cardiomyopathy (ChC) than in patients with non-dilated chagasic cardiomyopathy. However, its prognostic value was not established in patients with ChC. METHODS Forty-nine patients w...
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| Format: | Article |
| Language: | English |
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Fundação Oswaldo Cruz (FIOCRUZ)
2018-08-01
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| Series: | Memorias do Instituto Oswaldo Cruz |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762018001000300&lng=en&tlng=en |
| _version_ | 1797720703768723456 |
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| author | Henrique S Costa Marcia Maria O Lima Pedro Henrique S Figueiredo Patrícia M Martinelli Elizabeth RS Camargos Ana Thereza Chaves Maria Carmo Pereira Nunes Manoel Otavio C Rocha |
| author_facet | Henrique S Costa Marcia Maria O Lima Pedro Henrique S Figueiredo Patrícia M Martinelli Elizabeth RS Camargos Ana Thereza Chaves Maria Carmo Pereira Nunes Manoel Otavio C Rocha |
| author_sort | Henrique S Costa |
| collection | DOAJ |
| description | BACKGROUND Serum brain-derived neurotrophic factor (BDNF) levels have been shown to be lower in patients with Chagas cardiomyopathy (ChC) than in patients with non-dilated chagasic cardiomyopathy. However, its prognostic value was not established in patients with ChC. METHODS Forty-nine patients with ChC (50 ± 7 years, New York Heart Association “NYHA” I-III); were evaluated by echocardiography, exercise testing, and blood analysis. Serum BDNF levels were determined using enzyme-linked immunosorbent assay sandwich. Patients were followed-up, and cardiac death was considered the end-point. The survival analyses were performed using Kaplan-Meier and Cox regression. RESULTS After 39 ± 14 months of follow-up, 12 patients (25%) died. The concentration of 2.5 ng/mL was the optimal cut-off value to predict survival with significant difference between the groups with low (≤ 2.5 ng/mL) and high (> 2.5 ng/mL) BDNF levels (p = 0.006). Lower serum BDNF levels (hazards ratio (HR) 1.1, 95% confidence interval (CI) 1.1-1.4; p = 0.001), peak oxygen uptake (HR 1.2, 95% CI 1.0-1.3; p = 0.009), and left ventricular ejection fraction (HR 0.8, 95% CI 0.7-0.9; p = 0.001) were the independent predictors of survival. The combination of low serum BDNF levels and reduced left ventricular ejection fraction were highly predictive of death (HR 5.6, 95% CI: 1.2-9.7; p = 0.026). CONCLUSION In patients with ChC, reduced serum BDNF levels, especially if associated with systolic function, may provide useful prognostic information. |
| first_indexed | 2024-03-12T09:24:18Z |
| format | Article |
| id | doaj.art-7c588c5ad1e64f5697546c01a02996d4 |
| institution | Directory Open Access Journal |
| issn | 1678-8060 |
| language | English |
| last_indexed | 2024-03-12T09:24:18Z |
| publishDate | 2018-08-01 |
| publisher | Fundação Oswaldo Cruz (FIOCRUZ) |
| record_format | Article |
| series | Memorias do Instituto Oswaldo Cruz |
| spelling | doaj.art-7c588c5ad1e64f5697546c01a02996d42023-09-02T14:21:15ZengFundação Oswaldo Cruz (FIOCRUZ)Memorias do Instituto Oswaldo Cruz1678-80602018-08-011131010.1590/0074-02760180224S0074-02762018001000300Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathyHenrique S CostaMarcia Maria O LimaPedro Henrique S FigueiredoPatrícia M MartinelliElizabeth RS CamargosAna Thereza ChavesMaria Carmo Pereira NunesManoel Otavio C RochaBACKGROUND Serum brain-derived neurotrophic factor (BDNF) levels have been shown to be lower in patients with Chagas cardiomyopathy (ChC) than in patients with non-dilated chagasic cardiomyopathy. However, its prognostic value was not established in patients with ChC. METHODS Forty-nine patients with ChC (50 ± 7 years, New York Heart Association “NYHA” I-III); were evaluated by echocardiography, exercise testing, and blood analysis. Serum BDNF levels were determined using enzyme-linked immunosorbent assay sandwich. Patients were followed-up, and cardiac death was considered the end-point. The survival analyses were performed using Kaplan-Meier and Cox regression. RESULTS After 39 ± 14 months of follow-up, 12 patients (25%) died. The concentration of 2.5 ng/mL was the optimal cut-off value to predict survival with significant difference between the groups with low (≤ 2.5 ng/mL) and high (> 2.5 ng/mL) BDNF levels (p = 0.006). Lower serum BDNF levels (hazards ratio (HR) 1.1, 95% confidence interval (CI) 1.1-1.4; p = 0.001), peak oxygen uptake (HR 1.2, 95% CI 1.0-1.3; p = 0.009), and left ventricular ejection fraction (HR 0.8, 95% CI 0.7-0.9; p = 0.001) were the independent predictors of survival. The combination of low serum BDNF levels and reduced left ventricular ejection fraction were highly predictive of death (HR 5.6, 95% CI: 1.2-9.7; p = 0.026). CONCLUSION In patients with ChC, reduced serum BDNF levels, especially if associated with systolic function, may provide useful prognostic information.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762018001000300&lng=en&tlng=enbrain-derived neurotrophic factorChagas cardiomyopathyechocardiogramexercise testingprognosis |
| spellingShingle | Henrique S Costa Marcia Maria O Lima Pedro Henrique S Figueiredo Patrícia M Martinelli Elizabeth RS Camargos Ana Thereza Chaves Maria Carmo Pereira Nunes Manoel Otavio C Rocha Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy Memorias do Instituto Oswaldo Cruz brain-derived neurotrophic factor Chagas cardiomyopathy echocardiogram exercise testing prognosis |
| title | Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy |
| title_full | Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy |
| title_fullStr | Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy |
| title_full_unstemmed | Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy |
| title_short | Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy |
| title_sort | prognostic value of serum brain derived neurotrophic factor levels in patients with chagas cardiomyopathy |
| topic | brain-derived neurotrophic factor Chagas cardiomyopathy echocardiogram exercise testing prognosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762018001000300&lng=en&tlng=en |
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