1921
Volume 70, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

The extent of inflammation, fibrosis, and progression of chronic Chagas heart disease (cChHD) was associated with persistence of parasite DNA in cardiac lesions of necropsies or explants from Argentinean cChHD patients. A -based polymerase chain reaction showed a positive result in 1) 15% of cardiac sections with less than 10 mononuclear inflammatory cells/high-power field (440×) (MNC/HPF), 89% with 10–19 MNC/HPF, and 100% with more than 20 MNC/HPF ( < 0.0001); 2) 33% with less than 10% fibrosis, 79% with 10–19% fibrosis, and 100% with more than 20% fibrosis ( < 0.01); 3) 25% of specimens from patients classified in Kuschnir groups 0 and I, 70% in group II and 90% in group III ( < .001); and 4) 45% and 90% of the specimens from cChHD patients without or with heart failure, respectively ( < 0.01). These findings stress the role of the parasite in pathogenesis and disease progression of cChHD.

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References

  1. Moncayo A, 1999. Progress towards the interruption of transmission of Chagas disease in the southern countries. Medicina (B Aires) 59 (suppl 2): 120–124. [Google Scholar]
  2. Rosenbaum MB, 1964. Chagasic myocardiomyopathy. Prog Cardiovasc Dis 7 : 199–225. [Google Scholar]
  3. Storino R, Milei J, 1994. Evolución natural y estudios longitudinales. Storino R, Milei J, eds. Enfermedad de Chagas. Buenos Aires: Mosby Doyma Argentina, 593–604.
  4. Brener Z, 1987. Pathogenesis and immunopathology of chronic Chagas’ disease. Mem Inst Oswaldo Cruz 82 (suppl): 215–219. [Google Scholar]
  5. Tarleton RL, Zhang L, 1999. Chagas disease etiology: autoimmunity or parasite persistence? Parasitol Today 15 : 94–99. [Google Scholar]
  6. Levin MJ, 1996. In chronic Chagas heart disease, don’t forget the parasite. Parasitol Today 12 : 415–416. [Google Scholar]
  7. Bellotti G, Bocchi EA, de Moraes AV, Higuchi ML, Barbero-Marcial M, Sosa E, Esteves-Filho A, Kalil R, Weiss R, Jatene A, Pileggi F, 1996. In vivo detection of Trypanosoma cruzi antigens in hearts of patients with chronic Chagas’ heart disease. Am Heart J 131 : 301–307. [Google Scholar]
  8. Jones EM, Colley DG, Tostes S, Reis Lopes E, Vnencak-Jones CL, McCurley TL, 1993. Amplification of a Trypanosoma cruzi DNA sequence from inflammatory lesions in human chagasic cardiomyopathy. Am J Trop Med Hyg 48 : 348–357. [Google Scholar]
  9. Vago AR, Andrade LO, Leite AA, d’Avila Reis D, Macedo AM, Adad SJ, Tostes S Jr, Moreira MC, Filho GB, Pena SD, 2000. Genetic characterization of Trypanosoma cruzi directly from tissues of patients with chronic Chagas disease: differential distribution of genetic types into diverse organs. Am J Pathol 156 : 1805–1809. [Google Scholar]
  10. Olivares-Villagomez D, McCurley TL, Vnencak-Jones CL, Correa-Oliveira R, Colley DG, Carter CE, 1998. Polymerase chain reaction amplification of three different Trypanosoma cruzi DNA sequences from human chagasic cardiac tissue. Am J Trop Med Hyg 59 : 563–570. [Google Scholar]
  11. Anez N, Carrasco H, Parada H, Crisante G, Rojas A, Fuenmayor C, Gonzalez N, Percoco G, Borges R, Guevara P, Ramirez JL, 1999. Myocardial parasite persistence in chronic chagasic patients. Am J Trop Med Hyg 60 : 726–732. [Google Scholar]
  12. Kuschnir E, Sgammini H, Castro R, Evequoz C, Ledesma R, Brunetto J, 1985. Valoración de la función cardiáca por angiografía radioisotópica en pacientes con cardiopatía chagásica crónica. Arq Bras Cardiol 45 : 249–256. [Google Scholar]
  13. Edwards WD, Tajik AJ, Seward JB, 1981. Standardized nomenclature and anatomic basis for regional tomographic analysis of the heart. Mayo Clin Proc 56: 479–497. [Google Scholar]
  14. Aretz HT, Billingham ME, Edwards WD, Factor SM, Fallon JT, Fenoglio JJ Jr, Olsen EG, Schoen FJ, 1987. Myocarditis. A histopathologic definition and classification. Am J Cardiovasc Pathol 1 : 3–14. [Google Scholar]
  15. Kunkel B, Llapp H, Kober G, Kaltenbach M, 1978. Light microscopic evaluation of myocardial biopsies. Kaltenbach M, Loogen F, Olsen, EGJ, eds. Cardiomyopathy and Myocardial Biopsy. Berlin: Springer Verlag, 62–70.
  16. Schijman AG, Vigliano C, Burgos JM, Favaloro R, Perrone S, Laguens R, Levin M, 2000. Early diagnosis of recurrence of Trypanosoma cruzi infection by polymerase chain reaction after heart transplantation of a chronic Chagas’ heart disease patient. J Heart Lung Transplant 19 : 1114–1117. [Google Scholar]
  17. Brandariz S.; Schijman A.; Vigliano C.; Arteman P., Viotti R., Armenti H.; Beldjord C, Levin MJ, 1995. Detection of Trypanosoma cruzi DNA from archival heart tissue of a chronic Chagas’ disease reference case. Lancet 346 : 1370–1371. [Google Scholar]
  18. Schijman AG, Altcheh J, Burgos JM, Biancardi M, Bisio M, Levin M, Freilij H, 2003. Aetiological treatment of congenital Chagas’ disease diagnosed and monitored by the polymerase chain reaction. J Antimicrob Chemother 52 : 441–449. [Google Scholar]
  19. Vazquez M, Lorenzi H, Schijman AG, Ben-Dov C, Levin MJ, 1999. Analysis of the distribution of SIRE in the nuclear genome of Trypanosoma cruzi. Gene 239 : 207–216. [Google Scholar]
  20. Elias F, Vigliano C, Laguens R, Levin MJ, Berek C, 2003. Analysis of the presence of Trypanosoma cruzi in the heart tissue of three patients with chronic Chagas’ heart disease. Am J Trop Med Hyg 68 : 242–247. [Google Scholar]
  21. Andrade ZA, Andrade SG, 1999. Patologia. Brener Z, Andrade ZA, eds. Trypanosoma cruzi e Doença de Chagas. Rio de Janeiro: Guanabara Koogan, 199–248.
  22. Machado CR, Camargos ER, Guerra LB, Moreira MC, 2000. Cardiac autonomic denervation in congestive heart failure: comparison of Chagas’ heart disease with other dilated cardiomyopathy. Hum Pathol 31 : 3–10. [Google Scholar]
  23. Higuchi ML, Fukasawa S, De Brito T, Parzianello LC, Bellotti G, Ramirez JAF, 1999. Different microcirculatory and interstitial matrix patterns in idiopathic dilated cardiomyopathy and Chagas’ disease: a three dimensional confocal microscopy study.Heart 82 : 279–285. [Google Scholar]
  24. Kühl U, Noutsias M, Seeberg B, Schultheiss H-P, 1996. Immunohistological evidence for a chronic intramyocardial inflammatory process in dilated cardiomyopathy. Heart 75 : 295–300. [Google Scholar]
  25. Unverferth DV, Baker PB, Swift SE, Chaffee R, Fetters JK, Uretsky BF, Thompson ME, Leier CV, 1986. Extent of myocardial fibrosis and cellular hypertrophy in dilated cardiomyopathy. Am J Cardiol 57 : 816–820. [Google Scholar]
  26. Beltrami CA, Finato N, Rocco M, Feruglio GA, Puricelli C, Cigola E, Sonnenblick EH, Olivetti G, Anversa P, 1995. The cellular basis of dilated cardiomyopathy in humans. J Mol Cell Cardiol 27 : 291–305. [Google Scholar]
  27. Raso P, Tafuri WL, 1971. Alterações do pericárdio na fase crônica da tripanossomíase humana e nas fases aguda e crónica da moléstia experimental. Rev Soc Bras Med Trop Sao Paulo 5 : 135–153. [Google Scholar]
  28. Maguire JH, Hoff R, Sherlock I, Guimaraes AC, Sleigh AC, Ramos NB, Mott KE, Weller TH, 1987. Cardiac morbidity and mortality due to Chagas’ disease: prospective electrocardiographic study of a Brazilian community. Circulation 75 : 1140–1145. [Google Scholar]
  29. Laranja F, Dias E, Nobrega G, Miranda A, 1956. Chagas’ disease: a clinical epidemiologic and pathologic study. Circulation 14 : 1035–1060. [Google Scholar]
  30. Andrade ZA, 1985. Bases morfológicas das arritmias na miocardite chagásica. Cançado JR, Chuster M, eds. Cardiopatia Chagásica. Belo Horizonte, Brazil: Fundaçao Carlos Chagas 79–90.
  31. Kierszenbaum F, 1999. Chagas’ disease and the autoimmunity hypothesis. Clin Microbiol Rev 12 : 210–233. [Google Scholar]
  32. Köberle F, 1958. Cardiopatia chagásica. O Hosp 53 : 311–346. [Google Scholar]
  33. Mott KE, Hagstrom JWC, 1965. The pathologic lesions of the cardiac autonomic nervous system in chronic Chagas’ myocarditis. Circulation 31 : 273–286. [Google Scholar]
  34. Higuchi ML, Reis MM, Aiello VD, Benvenuti LA, Gutierrez PS, Bellotti G, Pileggi F, 1997. Association of an increase in CD8+ T cells with the presence of Trypanosoma cruzi antigens in chronic, human, chagasic myocarditis. Am J Trop Med Hyg 56 : 485–489. [Google Scholar]
  35. Zhang L, Tarleton RL, 1999. Parasite persistence correlates with disease severity and localization in chronic Chagas’ disease. J Infect Dis 180 : 480–486. [Google Scholar]
  36. Masuda MO, Levin M, de Oliveira SF, dos Santos Costa PC, Bergami PL, dos Santos Almeida NA, Pedrosa RC, Ferrari I, Hoebeke J, Campos de Carvalho AC. 1998. Functionally active cardiac antibodies in chronic Chagas’ disease are specifically blocked by Trypanosoma cruzi antigens. FASEB J 12 : 1551–1558. [Google Scholar]
  37. Chiale PA, Ferrari I, Mahler E, Vallazza MA, Elizari MV, Rosenbaum MB, Levin MJ, 2001. Differential profile and biochemical effects of antiautonomic membrane receptro antibodies in ventricular arrhythmias and sinus node dysfunction. Circulation 103 : 1765–1771. [Google Scholar]
  38. Viotti R, Vigliano C, Armenti H, Segura E, 1994. Treatment of chronic Chagas’ disease with benznidazole: clinical and serologic evolution of patients with long-term follow-up. Am Heart J 127 : 151–162. [Google Scholar]
  39. Urbina JA, 2001. Specific treatment of Chagas disease: current status and new developments. Curr Opin Infect Dis 14 : 733–741. [Google Scholar]
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  • Received : 01 Aug 2003
  • Accepted : 22 Oct 2003

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