Prevalence of Trypanosoma cruzi antibodies and inflammatory markers in uncompensated heart failure.
BACKGROUND
Heart failure (HF) represents the final stage of chronic chagasic cardiomyopathy (CChC). The diagnosis of CChC is based on the demonstration of anti-Trypanosoma cruzi antibodies (aTcAg) and clinical and epidemiological data. In Venezuela, there are no data about the prevalence of chagasic HF. The aim of this study was to determine the epidemiological, clinical, and inflammatory risk factors associated with seronegative or seropositive HF patients.


METHODS
We performed a cross-sectional study in the Venezuelan central-west states among a healthy rural population and in patients admitted to the emergency room with uncompensated HF.


RESULTS
The seroprevalence rates of Trypanosoma cruzi antibodies were 11.2% and 40.1% in the healthy population and in HF patients, respectively. Seropositivity in healthy individuals was associated with age, knowledge on triatomine vectors, and having seen wild reservoirs in the house; in HF patients, with contact with the vector and previous clinical diagnosis of Chagas' disease; and in both groups taken together, with age, knowledge on triatomines, and HF. Seropositive patients had prolonged QRS, decreased ejection fraction, and high serum magnesium, all significant as compared with HF seronegative cases. Left atrium enlargement and ventricular hypertrophy were most frequently observed in HF seronegative patients. CRP, IL6, ILβ1, IL2, and FNTα were elevated in 94.5%, 48%, 17.8%, 13.7%, and 6.9% of HF patients, respectively, but only IL2 levels were associated with chagasic HF.


CONCLUSIONS
There is a high prevalence of aTcAg in HF patients from the central-west region of Venezuela, and their epidemiological, clinical, and inflammatory features are discreetly different as compared with those of seronegative cases.
Unidade de Bioquímica, Decanato de Ciencias de la Salud, Universidade Centro-Occidental Lisandro Alvarado Barquisimeto, Estado Lara, Venezuela.
Iván
I
Bravo Tobar
Freddy
F
Parra
Carlota
C
Nello Pérez
Claudina
C
Rodríguez-Bonfante
Franco
F
Useche
Rafael
R
Bonfante-Cabarcas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000913:Antibodies, Protozoan / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002598:Chagas Cardiomyopathy / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D002908:Chronic Disease; D016207:Cytokines / Q000097:blood; D004562:Electrocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000469:parasitology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D014349:Trypanosoma cruzi / Q000276:immunology*; D014687:Venezuela / Q000453:epidemiology; D055815:Young Adult
D000913:Antibodies, Protozoan; D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein