Biochemical characterization of myocardial damage in chronic chagas' disease

Background: In the early asymptomatic stages of cardiomyopathy in chronic Chagas' disease, septal endomyocardial biopsies disclose multiple evidence of evolving myocardial damage. Detection of signs of an active myocardiopathic process may allow a better understanding of the evolution of this a...

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Published in:	Clinical cardiology (Mahwah, N.J.) Vol. 20; no. 10; pp. 865 - 869
Main Authors:	Carrasco G., Hugo A., Olmos, Leopoldo, Dipaolo, Alberto, Alarcon, Marino, Burguera, José, Burguera, Marcela, Carrasco V., Hugo R.
Format:	Journal Article
Language:	English
Published:	New York Wiley Periodicals, Inc 01-10-1997 Wiley
Subjects:	Adult Biological and medical sciences Biomarkers Cardiac Catheterization Chagas Cardiomyopathy - blood Chagas Cardiomyopathy - metabolism Chagas Cardiomyopathy - physiopathology Chagas' disease Chronic Disease Clinical Investigation Clinical Investigations coronary sinus Discriminant Analysis early myocardial damage Electrocardiography Electrolytes - metabolism Endocardium - metabolism enzymatic Female Fructose-Bisphosphate Aldolase - metabolism glycoproteic and electrolytic changes Glycoproteins - metabolism Human protozoal diseases Humans Infectious diseases Male Medical sciences Myocardium - metabolism Parasitic diseases Protozoal diseases Tropical medicine Trypanosomiasis Human Protozoal disease Cardiomyopathy Enzyme Chagas disease Cardiovascular disease Exploration Glycoproteins Parasitosis Myocardial disease Infection Electrodiagnosis Chronic Electrolyte Heart disease Electrocardiography Complication Trypanosomiasis
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Summary:	Background: In the early asymptomatic stages of cardiomyopathy in chronic Chagas' disease, septal endomyocardial biopsies disclose multiple evidence of evolving myocardial damage. Detection of signs of an active myocardiopathic process may allow a better understanding of the evolution of this and other related dilated cardiomyopathies and provide a means for evaluation of the result of future therapeutic schemes. Hypothesis: This study was designed to explore whether cellular damage caused by Chagas' disease is reflected by changes of certain serum electrolytes, enzymes, and glycoproteins associated with myocardial metabolism, especially in the coronary sinus into which the blood just metabolized by the heart is drained. Methods: The study included 47 patients (35 men and 12 women, average age 40 years) with positive complement fixation reaction and hemagglutination test for Chagas' disease. The study protocol included medical records, electrocardiographic (ECG) recordings, routine laboratory analysis, chest x‐rays, noninvasive cardiac examinations, and cardiac catheterization. Results: In this study, we determined the concentration or activity of 9 electrolytes, 5 glycoprotein fractions, and 12 enzymes related to cardiac metabolism in blood from the coronary sinus, the superior vena cava, the pulmonary and femoral arteries, and found early release of inorganic phosphorus (p<0.01) and isocitrate dehydrogenase (p<0.01) from the heart and increased activity of serum alkaline phosphatase and aldolase (p<0.05). Discriminant analysis suggested that the combination of the clinical picture, electrocardiographic findings, and peripheral activity of serum aldolase might be useful for the recognition of 86% of patients with Chagas' disease without segmental myocardial damage, 80% of those with early segmental abnormalities, and all patients with advanced myocardial damage or congestive heart failure. Conclusion: These results would make the application of more invasive techniques, such as left cineventriculography for detection of early myocardial compromise, unnecessary.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0160-9289 1932-8737
DOI:	10.1002/clc.4960201013