title: ADENOSINE DEAMINASE ACTIVITY AND SERUM C-REACTIVE PROTEIN AS PROGNOSTIC MARKERS OF CHAGAS DISEASE SEVERITY.
abstract: Chagas disease is a public health problem worldwide. The availability of diagnostic tools to predict the development of chronic Chagas cardiomyopathy is crucial to reduce morbidity and mortality. Here we analyze the prognostic value of adenosine deaminase serum activity (ADA) and C-reactive protein serum levels (CRP) in chagasic individuals. One hundred and ten individuals, 28 healthy and 82 chagasic patients were divided according to disease severity in phase I (n = 35), II (n = 29), and III (n = 18). A complete medical history, 12-lead electrocardiogram, chest X-ray, and M-mode echocardiogram were performed on each individual. Diagnosis of Chagas disease was confirmed by ELISA and MABA using recombinant antigens; ADA was determined spectrophotometrically and CRP by ELISA. The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases. Also, CRP and ADA were positively correlated with echocardiographic parameters of cardiac remodeling and with electrocardiographic abnormalities, and negatively with ejection fraction. CRP and ADA were higher in patients with cardiothoracic index ≥ 50%, while ADA was higher in patients with ventricular repolarization disturbances. Finally, CRP was positively correlated with ADA. In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.
authors.affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.
authors.forename: Iván Darío
authors.initials: ID
authors.lastname: Bravo-Tobar
authors.affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.
authors.forename: Carlota
authors.initials: C
authors.lastname: Nello-Pérez
authors.affiliation: Hospital de Chabasquén, Ministerio del Poder Popular para la Salud, Chabasquén, Venezuela.
authors.forename: Alí
authors.initials: A
authors.lastname: Fernández
authors.affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.
authors.forename: Nora
authors.initials: N
authors.lastname: Mogollón
authors.affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.
authors.forename: Mary Carmen
authors.initials: MC
authors.lastname: Pérez
authors.affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.
authors.forename: Juan
authors.initials: J
authors.lastname: Verde
authors.affiliation: Facultad de Ciencias, Universidad de los Andes, Mérida, Venezuela.
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Concepción
authors.affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.
authors.forename: Claudina
authors.initials: C
authors.lastname: Rodriguez-Bonfante
authors.affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.
authors.forename: Rafael
authors.initials: R
authors.lastname: Bonfante-Cabarcas
mesh_terms: D000243:Adenosine Deaminase / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D002598:Chagas Cardiomyopathy / Q000097:blood; D014355:Chagas Disease / Q000097:blood* / Q000201:enzymology; D002908:Chronic Disease; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D013053:Spectrophotometry
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D000243:Adenosine Deaminase