title: Impact of the Use of Benznidazole Followed by Antioxidant Supplementation in the Prevalence of Ventricular Arrhythmias in Patients With Chronic Chagas Disease: Pilot Study.
abstract: Patients with chronic Chagas disease have a higher prevalence of premature ventricular contraction (PVC) because of immunoinflammatory response magnified by the increased oxidative stress. Thus, the sequential treatment with benznidazole (BZN) and antioxidants can reduce the prevalence of PVC. We wish to establish whether the etiological treatment of Chagas disease followed by supplementation with the antioxidant vitamins E and C decreases the prevalence of PVC in these patients. A sample of 41 patients with chronic Chagas disease at different stages of the heart disease was selected for the treatment against the causative agent using BZN (5 mg·kg·d, minimum dose 300 mg daily) for 2 months followed by supplementation with antioxidants such as vitamins E (800 UI/d) and C (500 mg/d) for 6 months. The prevalence of PVC was observed by conducting 24-hour Holter. To evaluate the oxidative status of the patients, serum markers of oxidative stress like glutathione peroxidase, superoxide dismutase, catalase, glutathione reductase, and glutathione S-transferase were measured, and also reduced glutathione, vitamin E, and markers of tissue damage like thiobarbituric acid reactive substances and protein carbonyl. A decrease in the prevalence of PVC in patients with advanced Chagas heart disease was observed (5391 vs. 1185, P = 0.0068). This reduction was followed by decrease of serum markers of oxidative stress. In patients with a lower degree of cardiac damage, the reduction on prevalence of PVC was not significant. The etiological treatment with BZN followed by supplementation with antioxidant vitamins E and C reduces episodes of PVC in patients with severe Chagas heart disease.
authors.affiliation: 1National Institute of Cardiology, Rio de Janeiro, Brazil; 2Service of Cardiology, University Hospital Clementino Fraga Filho/Edson Saad Cardiology Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 3Department of Cardiology, Alberto Luiz Coimbra Institute for Postgraduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 4Service of Biostatistics and Applied Statistics, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 5Department of Ecology and Zoology, Federal University of Santa Catarina, Florianópolis, Brazil; and 6Department of Cardiology, Edson Saad Heart Institute, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: João Luís
authors.initials: JL
authors.lastname: Barbosa
authors.forename: Clarissa Antunes
authors.initials: CA
authors.lastname: Thiers
authors.forename: Basílio
authors.initials: B
authors.lastname: de Bragança Pereira
authors.forename: Emília Matos
authors.initials: EM
authors.lastname: do Nascimento
authors.forename: Carine Muniz
authors.initials: CM
authors.lastname: Ribeiro Frazon
authors.forename: Patricia
authors.initials: P
authors.lastname: Budni
authors.forename: Danilo
authors.initials: D
authors.lastname: Wilhelm Filho
authors.forename: Roberto Coury
authors.initials: RC
authors.lastname: Pedrosa
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D014355:Chagas Disease / Q000150:complications / Q000188:drug therapy*; D002908:Chronic Disease; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009593:Nitroimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D018384:Oxidative Stress / Q000187:drug effects; D010865:Pilot Projects; D015995:Prevalence; D014344:Trypanocidal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018879:Ventricular Premature Complexes / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D014810:Vitamin E / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D009593:Nitroimidazoles; D014344:Trypanocidal Agents; D014810:Vitamin E; D001205:Ascorbic Acid; C009999:benzonidazole