Abstract
BackgroundChagas disease (CD) induces autonomic dysfunction and inflammatory activity, which may promote metabolic abnormalities. We studied metabolism and his correlation with Autonomic Nervous System (ANS) and inflammation in CD.Methods and ResultsSixty subjects were divided into 4 groups: control group (CG), IF (indeterminate form) group; ECG group (ECG abnormalities and normal left ventricular systolic function), and LVD group (left ventricular sistolic dysfunction). Levels of adiponectin, leptin, insulin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were assayed in serum samples by ELISA. ANS was assessed by heart rate variability in frequency domain in 24-hour Holter and postural tilt test (rest and orthostatic position). High frequency (HFr) component values were used to estimate parasympathetic activity and low frequency (LFr) component, sympathetic activity. Analyzes were made of the correlations of each of the metabolic parameters (leptin and adiponectin) with the inflammatory cytokines (interleukin-6 and TNF- alpha) and with the ANS assessment measurements. No significant differences were observed in leptin and insulin levels. Adiponectin was higher in ECG and LVD groups: [CG = 4766.5 (5529.5), IF = 4003.5 (2482.5), ECG = 8376.5 (8388.5), LVD = 8798 (4188.0) ng/mL, p<0.001)]. IL-6 and TNF-alpha were higher in LVD group: [IL-6: CG = 1.85 (6.41); IF = 1.58 (1.91); ECG = 1.0 (1.57); LVD= 31.44 (72.19) pg/ml; p = 0.001. TNF-alpha: CG = 22.57 (88.2); IF = 19.31 (33.16); ECG = 12.45 (3.07); LVD = 75.15 (278.57) pg/ml; p = 0.04]. Adiponectin levels had a positive association with the HFr component (r = 0.539; p = 0.038) and an inverse association with the LFr component (r = - 0.539; p = 0.038) in ECG group. Leptin levels had a negative association with the HFr component (r= - 0.632; p = 0.011) and a positive association with the LFr component (r = 0.632; p = 0.011) in LVD group.ConclusionsWe found increased adiponectin levels in Chagas’ heart disease with systolic dysfunction and in patients with ECG abnormalities and normal systolic function at rest. Adipocytokines levels (adiponectin and leptin) were associated with ANS parameters in Chagas’ heart disease.
Highlights
Chagas’ disease (CD) occurs from the southern United States to Patagonia and affects around 8 million people in Latin America [1]
Sixty subjects were divided into 4 groups: control group (CG), indeterminate form (IF) group; ECG group (ECG abnormalities and normal left ventricular systolic function), and LVD group
No significant differences were observed in leptin and insulin levels
Summary
Chagas’ disease (CD) occurs from the southern United States to Patagonia and affects around 8 million people in Latin America [1]. In the United States, it is estimated that 300 thousand legal immigrants may be infected with the disease. About 70% of the patients have no symptoms and routine examinations do not show any abnormalities. This stage is called indeterminate form (IF). The patients of IF form of Chagas’ disease, in general, have a very good prognosis. Survival in this group appears comparable to that of the general population [4]. The progression to myocardial dysfunction represents the leading cause of morbidity and mortality in Chagas’ disease [3]. We studied metabolism and his correlation with Autonomic Nervous System (ANS) and inflammation in CD
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