title: The relationship between heart rate variability and serum cytokines in chronic chagasic patients with persistent parasitemia.
abstract: BACKGROUND
  Persistent parasitemia, immunological, and autonomic nervous system impairments may play an important role in the evolution and clinical outcome of the chronic phase of Chagas' disease by triggering functional cardiovascular changes.
  
  
  METHODS
  Three groups were evaluated: 17 chronic chagasic patients with the indeterminate form (IChD), 12 chronic chagasic patients with cardiac forms (ChHD), and 29 individuals as a healthy control group. Parasitemia was assessed by polymerase chain reaction; hemoculture, heart rate variability by linear and nonlinear methods, and interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-12, IL-13, IL-17, and tumor necrosis factor-α, and interferon (IFN)-γ serum cytokines were assessed by enzyme-linked immune assay.
  
  
  RESULTS
  Twenty-nine chronic chagasic patients were positive for parasitemia (17 IChD and 12 ChHD). Heart rate variability parameters in baseline condition and after cold face test were significantly decreased in chagasic patients compared to controls. Tilt tests showed no alteration. However, using nonlinear indices, ChHD patients presented lower values compared to IChD and controls. Differences in the expression of serum cytokines were observed between chagasic patients and controls. However, among the groups, ChHD presented higher median values of IL-10 and lower of IFN-γ compared to IChD.
  
  
  CONCLUSIONS
  Both chagasic groups present an autonomic impairment using linear methods. The nonlinear methods revealed that the ChHD group had a higher cardiovascular risk. Serum cytokine concentrations between chagasic patients were similar. However, ChHD showed higher concentrations of IL-10 and lower of IFN-γ, suggesting some established process of immune regulation.
authors.affiliation: Internal Medicine Department, Infectious Division, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Llaguno
authors.forename: Luiz Antonio Rodrigues de Resende
authors.initials: LA
authors.lastname: Pertili
authors.forename: Marcos Vinicius
authors.initials: MV
authors.lastname: da Silva
authors.forename: Pablo
authors.initials: P
authors.lastname: Bunazar
authors.forename: Ariane Martim
authors.initials: AM
authors.lastname: Reges
authors.forename: Ana Carolina Guimarães
authors.initials: AC
authors.lastname: Faleiros
authors.forename: Eliane
authors.initials: E
authors.lastname: Lages-Silva
authors.forename: Virmondes
authors.initials: V
authors.lastname: Rodrigues Junior
authors.forename: Valdo José Dias
authors.initials: VJ
authors.lastname: da Silva
authors.forename: Dalmo
authors.initials: D
authors.lastname: Correia Filho
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D002598:Chagas Cardiomyopathy / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D002908:Chronic Disease; D016207:Cytokines / Q000097:blood*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
chemical_list: D015415:Biomarkers; D016207:Cytokines