title: Predictive value of transforming growth factor-β1in Chagas disease: towards a biomarker surrogate of clinical outcome.
abstract: BACKGROUND
  Transforming growth factor-β1 (TGF-β1) may be implicated in the development of Chagas heart disease. However, the clinical value of TGF-β1 measurement is yet to be determined.
  
  
  METHODS
  We retrospectively analyzed the outcome of 54 Chagas disease patients without heart failure and with left ventricular (LV) ejection fraction >45% whose TGF-β1 serum values were determined between January 1998 and December 1999. Primary end point was all-cause mortality and secondary end point was the combination of all-cause mortality or hospitalization due to worsening heart failure or cardiac arrhythmias.
  
  
  RESULTS
  TGF-β1 was independently associated with the occurrence of the primary and secondary end points. The optimal cutoff for TGF-β1 to identify the primary end point was 12.9 ng/ml (area under the curve = 0.82, p = 0.004, sensitivity 100%, and specificity 57%) and to identify the secondary end point was 30.8 ng/ml (area under the curve = 0.72, p = 0.03, sensitivity 60%, and specificity 86%). LV ejection fraction and LV end-diastolic diameter were also independent predictors of the primary and secondary endpoints, respectively.
  
  
  CONCLUSIONS
  The described association between TGF-β1 and clinical outcome provides evidence towards the clinical value of TGF-β1 in Chagas disease.
authors.affiliation: Evandro Chagas Clinical Research Institute, Rio de Janeiro, Brazil. roberto.saraiva@ipec.fiocruz.br
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Saraiva
authors.forename: Mariana C
authors.initials: MC
authors.lastname: Waghabi
authors.forename: Maíra F
authors.initials: MF
authors.lastname: Vilela
authors.forename: Fabiana S
authors.initials: FS
authors.lastname: Madeira
authors.forename: Gilberto M
authors.initials: GM
authors.lastname: Sperandio da Silva
authors.forename: Sérgio S
authors.initials: SS
authors.lastname: Xavier
authors.forename: Jean J
authors.initials: JJ
authors.lastname: Feige
authors.forename: Alejandro M
authors.initials: AM
authors.lastname: Hasslocher-Moreno
authors.forename: Tania C
authors.initials: TC
authors.lastname: Araujo-Jorge
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood*; D002598:Chagas Cardiomyopathy / Q000097:blood / Q000401:mortality; D014355:Chagas Disease / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D053773:Transforming Growth Factor beta1 / Q000032:analysis / Q000097:blood*
chemical_list: D015415:Biomarkers; D053773:Transforming Growth Factor beta1
keywords: Chagas disease; Echocardiography; Heart failure; Prognosis; Transforming growth factor-β1