Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease
Abstract INTRODUCTION: Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angi...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Medicina Tropical (SBMT)
2020-07-01
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| Series: | Revista da Sociedade Brasileira de Medicina Tropical |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100329&tlng=en |
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| author | Silvia Marinho Martins Alves Lúcia Elena Alvarado-Arnês Maria da Glória Aureliano de Melo Cavalcanti Cristina de Fátima Velloso Carrazzone Antônio Guilherme Fonseca Pacheco Camila Sarteschi Milton Ozorio Moraes Wilson Alves de Oliveira Junior Carolina de Araújo Medeiros Fernanda Gallinaro Pessoa Charles Mady Joseli Lannes-Vieira Felix José Alvarez Ramires |
| author_facet | Silvia Marinho Martins Alves Lúcia Elena Alvarado-Arnês Maria da Glória Aureliano de Melo Cavalcanti Cristina de Fátima Velloso Carrazzone Antônio Guilherme Fonseca Pacheco Camila Sarteschi Milton Ozorio Moraes Wilson Alves de Oliveira Junior Carolina de Araújo Medeiros Fernanda Gallinaro Pessoa Charles Mady Joseli Lannes-Vieira Felix José Alvarez Ramires |
| author_sort | Silvia Marinho Martins Alves |
| collection | DOAJ |
| description | Abstract INTRODUCTION: Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angiotensin II activity is a key player in the pathophysiology of HF. A functional polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with plasma enzyme activity. In CD, ACE inhibitors have beneficial effects supporting the use of this treatment in chagasic cardiomyopathy. METHODS: We evaluated the association of ACE I/D polymorphism with HF, performing a case-control study encompassing 343 patients with positive serology for CD staged as non-cardiomyopathy (stage A; 100), mild (stage B1; 144), and severe (stage C; 99) forms of Chagas heart disease. For ACE I/D genotyping by PCR, groups were compared using unconditional logistic regression analysis and adjusted for nongenetic covariates: age, sex, and trypanocidal treatment. RESULTS: A marginal, but not significant (p=0.06) higher prevalence of ACE I/D polymorphism was observed in patients in stage C compared with patients in stage A. Patients in stage C (CD with HF), were compared with patients in stages A and B1 combined into one group (CD without HF); DD genotype/D carriers were prevalent in the HF patients (OR = 2; CI = 1.013.96; p = 0.04). CONCLUSIONS: Our results of this cohort study, comprising a population from the Northeast region of Brazil, suggest that ACE I/D polymorphism is more prevalent in the cardiac form of Chagas disease with HF. |
| first_indexed | 2024-12-12T19:37:44Z |
| format | Article |
| id | doaj.art-a445ae3f8bf24c619a85bfc3432e62e0 |
| institution | Directory Open Access Journal |
| issn | 1678-9849 |
| language | English |
| last_indexed | 2024-12-12T19:37:44Z |
| publishDate | 2020-07-01 |
| publisher | Sociedade Brasileira de Medicina Tropical (SBMT) |
| record_format | Article |
| series | Revista da Sociedade Brasileira de Medicina Tropical |
| spelling | doaj.art-a445ae3f8bf24c619a85bfc3432e62e02022-12-22T00:14:16ZengSociedade Brasileira de Medicina Tropical (SBMT)Revista da Sociedade Brasileira de Medicina Tropical1678-98492020-07-015310.1590/0037-8682-0488-2019Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart DiseaseSilvia Marinho Martins AlvesLúcia Elena Alvarado-ArnêsMaria da Glória Aureliano de Melo CavalcantiCristina de Fátima Velloso CarrazzoneAntônio Guilherme Fonseca PachecoCamila SarteschiMilton Ozorio MoraesWilson Alves de Oliveira JuniorCarolina de Araújo MedeirosFernanda Gallinaro PessoaCharles MadyJoseli Lannes-VieiraFelix José Alvarez Ramireshttps://orcid.org/0000-0003-2437-2485Abstract INTRODUCTION: Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angiotensin II activity is a key player in the pathophysiology of HF. A functional polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with plasma enzyme activity. In CD, ACE inhibitors have beneficial effects supporting the use of this treatment in chagasic cardiomyopathy. METHODS: We evaluated the association of ACE I/D polymorphism with HF, performing a case-control study encompassing 343 patients with positive serology for CD staged as non-cardiomyopathy (stage A; 100), mild (stage B1; 144), and severe (stage C; 99) forms of Chagas heart disease. For ACE I/D genotyping by PCR, groups were compared using unconditional logistic regression analysis and adjusted for nongenetic covariates: age, sex, and trypanocidal treatment. RESULTS: A marginal, but not significant (p=0.06) higher prevalence of ACE I/D polymorphism was observed in patients in stage C compared with patients in stage A. Patients in stage C (CD with HF), were compared with patients in stages A and B1 combined into one group (CD without HF); DD genotype/D carriers were prevalent in the HF patients (OR = 2; CI = 1.013.96; p = 0.04). CONCLUSIONS: Our results of this cohort study, comprising a population from the Northeast region of Brazil, suggest that ACE I/D polymorphism is more prevalent in the cardiac form of Chagas disease with HF.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100329&tlng=enChagas diseaseACE I/D polymorphismCardiomyopathyHeart failure |
| spellingShingle | Silvia Marinho Martins Alves Lúcia Elena Alvarado-Arnês Maria da Glória Aureliano de Melo Cavalcanti Cristina de Fátima Velloso Carrazzone Antônio Guilherme Fonseca Pacheco Camila Sarteschi Milton Ozorio Moraes Wilson Alves de Oliveira Junior Carolina de Araújo Medeiros Fernanda Gallinaro Pessoa Charles Mady Joseli Lannes-Vieira Felix José Alvarez Ramires Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease Revista da Sociedade Brasileira de Medicina Tropical Chagas disease ACE I/D polymorphism Cardiomyopathy Heart failure |
| title | Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease |
| title_full | Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease |
| title_fullStr | Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease |
| title_full_unstemmed | Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease |
| title_short | Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease |
| title_sort | influence of angiotensin converting enzyme insertion deletion gene polymorphism in progression of chagas heart disease |
| topic | Chagas disease ACE I/D polymorphism Cardiomyopathy Heart failure |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100329&tlng=en |
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