Abstract

Background: The failure to translate preclinical results to the clinical setting is the rule, not the exception. One reason that is frequently overlooked is whether the animal model reproduces distinctive features of human disease. Another is the reproducibility of the method used to measure treatment effects in preclinical studies. Left ventricular (LV) function improvement is the most common endpoint in preclinical cardiovascular disease studies, while echocardiography is the most frequently used method to evaluate LV function. In this work, we conducted a robust echocardiographic evaluation of LV size and function in dogs chronically infected by Trypanosoma cruzi.Methods and Results: Echocardiography was performed blindly by two distinct observers in mongrel dogs before and between 6 and 9 months post infection. Parameters analyzed included end-systolic volume (ESV), end-diastolic volume (EDV), ejection fraction (EF), and fractional shortening (FS). We observed a significant LVEF and FS reduction in infected animals compared to controls, with no significant variation in volumes. However, the effect of chronic infection in systolic function was quite variable, with EF ranging from 17 to 66%. Using the cut-off value of EF ≤ 40%, established for dilated cardiomyopathy (DCM) in dogs, only 28% of the infected dogs were affected by the chronic infection.Conclusions: The canine model of CCC mimics human disease, reproducing the percentage of individuals that develop heart failure during the chronic infection. It is thus mandatory to establish inclusion criteria in the experimental design of canine preclinical studies to account for the variable effect that chronic infection has on systolic function.

Highlights

  • Chagas disease is caused by the protozoan parasite Trypanosoma cruzi

  • Out of 78 dogs initially infected for this study, 25 animals died during the acute phase of infection, resulting in a mortality rate of 32%

  • The observed mortality rate was much higher than expected for the acute phase of Chagas disease transmitted by insect vectors in humans, in which 0.25% of infected individuals die of severe myocarditis or meningoencephalitis (Rassi et al, 2010)

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Summary

Introduction

Chagas disease is caused by the protozoan parasite Trypanosoma cruzi. This parasite can be transmitted to humans, domestic, or wild mammals and the infection is very difficult to cure. ∼30% of infected individuals will develop chronic chagasic cardiomyopathy (CCC), which is characterized by episodes of sudden cardiac death (SCD) due to complex ventricular arrhythmias, cardiac dilation and heart failure (HF). One reason that is frequently overlooked is whether the animal model reproduces distinctive features of human disease. Another is the reproducibility of the method used to measure treatment effects in preclinical studies. We conducted a robust echocardiographic evaluation of LV size and function in dogs chronically infected by Trypanosoma cruzi

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