Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease
Background Chagas disease (CD) presents an ominous prognosis. The predictive value of biomarkers and new echocardiogram parameters in adjusted models have not been well studied. Methods and Results There were 361 patients with chronic CD (57.6% men, 61±11 years of age, clinical forms: indeterminate...
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Wiley
2023-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.028810 |
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| author | Veronica G. Mendes Lorena Rimolo Ana Carolina B. de Lima Roberto R. Ferreira Luciano S. Oliveira Lindice M. Nisimura Samuel I. M. Horita Andréa R. Costa Gilberto Marcelo S. da Silva Luiz Henrique C. Sangenis Fernanda S. N. S. Mendes Andrea S. Sousa Henrique H. Veloso Marcelo T. Holanda Mauro F. F. Mediano Mariana C. Waghabi Luciana R. Garzoni Otacílio C. Moreira Constança Britto Ademir B. Cunha Alejandro Marcel Hasslocher‐Moreno Roberto M. Saraiva |
| author_facet | Veronica G. Mendes Lorena Rimolo Ana Carolina B. de Lima Roberto R. Ferreira Luciano S. Oliveira Lindice M. Nisimura Samuel I. M. Horita Andréa R. Costa Gilberto Marcelo S. da Silva Luiz Henrique C. Sangenis Fernanda S. N. S. Mendes Andrea S. Sousa Henrique H. Veloso Marcelo T. Holanda Mauro F. F. Mediano Mariana C. Waghabi Luciana R. Garzoni Otacílio C. Moreira Constança Britto Ademir B. Cunha Alejandro Marcel Hasslocher‐Moreno Roberto M. Saraiva |
| author_sort | Veronica G. Mendes |
| collection | DOAJ |
| description | Background Chagas disease (CD) presents an ominous prognosis. The predictive value of biomarkers and new echocardiogram parameters in adjusted models have not been well studied. Methods and Results There were 361 patients with chronic CD (57.6% men, 61±11 years of age, clinical forms: indeterminate 27.1%, cardiac 56.6%, digestive 3.6%, cardiodigestive 12.7%) included in this single‐center, observational, prospective longitudinal study. Echocardiographic evaluation included strain analyses of left atrial, left ventricular (LV), and right ventricular and 3‐dimensional analyses of left atrial and LV volumes. Biomarkers included cardiac troponin I, brain natriuretic peptide, transforming growth factor β1, tumor necrosis factor, matrix metalloproteinases, and Trypanosoma cruzi polymerase chain reaction. The studied end point was a composite of CD‐related mortality, heart transplant, hospital admission due to worsening heart failure, or new cardiac device insertion. Event‐free survival was analyzed by multivariable regression analyses adjusted for competing risks. P values <0.05 were considered significant. The composite event occurred in 79 patients after 4.9±2.0 years follow‐up. LV end‐diastolic volume (hazard ratio [HR], 1.01 [95% CI, 1.00–1.02]; P=0.02), peak negative global atrial strain (HR, 1.08 [95% CI, 1.00–1.17]; P=0.04), LV global circumferential strain (HR, 1.12 [95% CI, 1.04–1.21]; P=0.003), LV torsion (HR, 0.55 [95% CI, 0.35–0.81]; P=0.003), brain natriuretic peptide (HR, 2.03 [95% CI, 1.23–3.34]; P=0.005), and positive T cruzi polymerase chain reaction (HR, 1.80 [95% CI, 1.12–2.91]; P=0.01) were end point predictors independent from age, sex, 2‐dimensional echocardiographic indexes, hypertension, previous cardiac device, and CD cardiac form. Conclusions Two‐dimensional strain‐ and 3‐dimensional‐derived parameters, brain natriuretic peptide, and positive T cruzi polymerase chain reaction can be useful for prediction of CD cardiovascular events. |
| first_indexed | 2024-03-13T04:20:55Z |
| format | Article |
| id | doaj.art-93e9388ceaaa460bacb9f13b8964e1bb |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-13T04:20:55Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-93e9388ceaaa460bacb9f13b8964e1bb2023-06-20T10:12:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-06-01121210.1161/JAHA.122.028810Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas DiseaseVeronica G. Mendes0Lorena Rimolo1Ana Carolina B. de Lima2Roberto R. Ferreira3Luciano S. Oliveira4Lindice M. Nisimura5Samuel I. M. Horita6Andréa R. Costa7Gilberto Marcelo S. da Silva8Luiz Henrique C. Sangenis9Fernanda S. N. S. Mendes10Andrea S. Sousa11Henrique H. Veloso12Marcelo T. Holanda13Mauro F. F. Mediano14Mariana C. Waghabi15Luciana R. Garzoni16Otacílio C. Moreira17Constança Britto18Ademir B. Cunha19Alejandro Marcel Hasslocher‐Moreno20Roberto M. Saraiva21Clinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilAntonio Pedro University Hospital Fluminense Federal University Niterói BrazilMolecular Biology and Endemic Diseases Laboratory Oswaldo Cruz Institute Rio de Janeiro BrazilLaboratory of Applied Genomics and Bioinnovations Oswaldo Cruz Institute Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilLaboratory of Innovations in Therapies, Education and Bioproducts Oswaldo Cruz Institute Rio de Janeiro BrazilLaboratory of Innovations in Therapies, Education and Bioproducts Oswaldo Cruz Institute Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilLaboratory of Applied Genomics and Bioinnovations Oswaldo Cruz Institute Rio de Janeiro BrazilLaboratory of Innovations in Therapies, Education and Bioproducts Oswaldo Cruz Institute Rio de Janeiro BrazilLaboratory of Molecular Virology and Parasitology Oswaldo Cruz Institute Rio de Janeiro BrazilMolecular Biology and Endemic Diseases Laboratory Oswaldo Cruz Institute Rio de Janeiro BrazilAntonio Pedro University Hospital Fluminense Federal University Niterói BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilClinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro BrazilBackground Chagas disease (CD) presents an ominous prognosis. The predictive value of biomarkers and new echocardiogram parameters in adjusted models have not been well studied. Methods and Results There were 361 patients with chronic CD (57.6% men, 61±11 years of age, clinical forms: indeterminate 27.1%, cardiac 56.6%, digestive 3.6%, cardiodigestive 12.7%) included in this single‐center, observational, prospective longitudinal study. Echocardiographic evaluation included strain analyses of left atrial, left ventricular (LV), and right ventricular and 3‐dimensional analyses of left atrial and LV volumes. Biomarkers included cardiac troponin I, brain natriuretic peptide, transforming growth factor β1, tumor necrosis factor, matrix metalloproteinases, and Trypanosoma cruzi polymerase chain reaction. The studied end point was a composite of CD‐related mortality, heart transplant, hospital admission due to worsening heart failure, or new cardiac device insertion. Event‐free survival was analyzed by multivariable regression analyses adjusted for competing risks. P values <0.05 were considered significant. The composite event occurred in 79 patients after 4.9±2.0 years follow‐up. LV end‐diastolic volume (hazard ratio [HR], 1.01 [95% CI, 1.00–1.02]; P=0.02), peak negative global atrial strain (HR, 1.08 [95% CI, 1.00–1.17]; P=0.04), LV global circumferential strain (HR, 1.12 [95% CI, 1.04–1.21]; P=0.003), LV torsion (HR, 0.55 [95% CI, 0.35–0.81]; P=0.003), brain natriuretic peptide (HR, 2.03 [95% CI, 1.23–3.34]; P=0.005), and positive T cruzi polymerase chain reaction (HR, 1.80 [95% CI, 1.12–2.91]; P=0.01) were end point predictors independent from age, sex, 2‐dimensional echocardiographic indexes, hypertension, previous cardiac device, and CD cardiac form. Conclusions Two‐dimensional strain‐ and 3‐dimensional‐derived parameters, brain natriuretic peptide, and positive T cruzi polymerase chain reaction can be useful for prediction of CD cardiovascular events.https://www.ahajournals.org/doi/10.1161/JAHA.122.0288102‐dimensional strain analysis3‐dimensional echocardiographyChagas diseasemortalityprognosis |
| spellingShingle | Veronica G. Mendes Lorena Rimolo Ana Carolina B. de Lima Roberto R. Ferreira Luciano S. Oliveira Lindice M. Nisimura Samuel I. M. Horita Andréa R. Costa Gilberto Marcelo S. da Silva Luiz Henrique C. Sangenis Fernanda S. N. S. Mendes Andrea S. Sousa Henrique H. Veloso Marcelo T. Holanda Mauro F. F. Mediano Mariana C. Waghabi Luciana R. Garzoni Otacílio C. Moreira Constança Britto Ademir B. Cunha Alejandro Marcel Hasslocher‐Moreno Roberto M. Saraiva Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 2‐dimensional strain analysis 3‐dimensional echocardiography Chagas disease mortality prognosis |
| title | Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease |
| title_full | Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease |
| title_fullStr | Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease |
| title_full_unstemmed | Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease |
| title_short | Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease |
| title_sort | biomarkers and echocardiographic predictors of cardiovascular outcome in patients with chronic chagas disease |
| topic | 2‐dimensional strain analysis 3‐dimensional echocardiography Chagas disease mortality prognosis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.028810 |
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