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Beta-blockade upon myocardial remodelling in Chagas' cardiomyopathy


Chagas' disease has spread throughout Latin America because of the high migration from these countries. About 30% of Chagas' patients will develop cardiomyopathy, and 10% of these will develop severe cardiac damage leading to heart failure. Beta blockade improves symptoms and survival in heart failure patients; however, it has not been well stablished in Chagas' disease. We evaluated the role of carvedilol in cardiac remodelling and mortality in a Chagas' cardiomyopathy animal model. We studied 55 Syrian Hamsters after T. cruzi infection divided into 3 groups: Control (15), Infected (20), and Infected + Carvedilol (20). Animals underwent echocardiography, electrocardiography, morphometry for collagen evaluation in ventricles stained with picrosirius red. Left ventricular diastolic diameter did not change between groups, although it was slightly larger in infected groups, as was left ventricular systolic diameter. Fractional shortening also did not change between groups, although it was slightly lower in infected groups. Collagen accumulation in the interstitial myocardial space was significantly higher in infected groups, and carvedilol did not attenuate it. The same response was observed in the perivascular space. The survival curve showed significantly better survival in the control group compared with the infected groups; and no benefit of carvedilol was observed during the study. However looking only at the acute phase (up to 100 days of infection), carvedilol did reduce mortality. Carvedilol did not attenuate cardiac remodelling or mortality in this model of Chagas' cardiomyopathy. The treatment did improve survival in the acute phase of the disease. (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DE SOUZA PIMENTEL, WALACE; ALVAREZ RAMIRES, FELIX JOSE; IANNI, BARBARA MARIA; CURY SALEMI, VERA MARIA; BIANCHI BILATE, ANGELINA MORAND; CUNHA-NETO, EDECIO; DE OLIVEIRA, ADRIANA MORGAN; FERNANDES, FABIO; MADY, CHARLES. The effect of beta-blockade on myocardial remodelling in Chagas' cardiomyopathy. Clinics, v. 67, n. 9, p. 1063-1069, . (12/11438-4)

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