Evaluation of the development of coronary atherosclerosis in chagasic and nonchagasic patients

Evaluation of the development of coronary atherosclerosis in chagasic and nonchagasic patients

• Autor
• Weslley Fernandes-Braga
• Co-autores
• Ildernandes Vieira-Alves , William bruno Alves da Silva , Edenil Costa Aguilar , Bruno Almeida Rezende , Cláudio Léo Gelape , Jacqueline Isaura Alvarez-Leite , Steyner de França Côrtes , Rafaela Fernandes da Silva , Virgínia Soares Lemos
• Resumo

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  Chagas' disease (ChD), originally a South American endemic health problem, is expanding worldwide. Its main impact is on the cardiovascular system, producing myocardial damage that frequently results in heart failure. It has been suggested that Trypanosoma cruzi infection increases the release of reactive oxygen species (ROS) by stimulating inflammatory mediators, which then may contribute to development of atherosclerosis. However, the frequency of atherosclerotic coronary artery disease (ACAD) in patients with ChD remains undefined in the literature. Therefore, we aimed to investigate the development of coronary artery atherosclerosis in patients who had undergone heart transplantation with chronic Chagas ’disease, comparing with a control group without ChD. Seventy-three patients were studied, 32 chronic chagasic and 41 nonchagasic. The right coronary artery of discarded hearts was removed and processed for histological, immunohistochemistry and molecular biology analysis. Comparisons between groups were performed using Fisher's Exact and Mann-Whitney test. This study was approved by the Research Ethics Committee (CAAE 82255517.4.0000.5149). So far, the analysis was performed in samples of 34 patients (16 from chronic chagasic and 18 from nonchagasic group). Coronary atherosclerosis was detected in 11 patients of chagasic group (ChD; 68.8%) and in 15 patients of nonchagasic group (NChD; 83.3%). However, there was no statistical difference between the groups (p= 0.43). Morphology of coronary arteries was similar for both groups, showing the same total vascular area (ChD 4.11±1.88 vs. NChD 5.19±1.91mm², p=0.12) and stenosis (ChD 37.77±13.38 vs. NChD 38.95±17.87, p=0.98). Immunohistochemistry analysis performed for CD68, showed a similar infiltration of macrophages in both groups (ChD 3.35±2.53 vs. NChD 4.46±3.44, p=0.46). Quantification by RT-PCR showed also a similar expression between groups of inflammatory cytokines (MCP-1, IFN-gama, TNF, IL-6, IL-10 and IL-12). In conclusion, no changes were found in vascular morphology or inflammation, related to CD. Therefore, no prevalence of CAD was observed in chagasic individuals.

   

• Palavras-chave
• Chagas’ disease, atherosclerosis, heart failure.
• Modalidade
• Comunicação oral
• Área Temática
• Inflamação e doenças vasculares