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Metabolic and inflammatory mediators in patients with idiopathic dilated cardiomyopathy and Chagas' disease: correlation with autonomic dysfunction

Abstract

Objectives: General: Assessment of metabolism and inflammatory activity in patients with idiopathic dilated cardiomyopathy and Chagas' disease and its correlation with measures of autonomic nervous system function. Specific: To determine the levels of metabolic markers: adipocytokines (adiponectin and leptin), glucose, insulin, insulin resistance index and blood lipids in patients with idiopathic dilated cardiomyopathy and Chagas disease; determine the levels of inflammatory cytokines such as interleukin-6 and factor Tumor necrosis in patients with idiopathic dilated cardiomyopathy and Chagas disease. Correlate the various metabolic and inflammatory markers studied with measures of function Autonomic Nervous System. Patients: 45 patients will be divided into three groups of 15 patients each (all groups will be paired together according to age and sex): a) Patients with dilated cardiomyopathy and left ventricular systolic dysfunction, b) patients with Chagas disease and left ventricular systolic dysfunction (<40% by echocardiography Teicholz method). Control group: Healthy people without a diagnosis of cardiomyopathy or ventricular dysfunction with normal (body mass index (BMI). Inclusion criteria: positive serology for Chagas' disease in two different methods (indirect immunofluorescence and ELISA), dilated cardiomyopathy; age over 18 years, both gender, normal BMI. Exclusion criteria: BMI (<18.5 or> 25 kg/m2), smoking, valvular heart disease moderate or severe; hypertension, diabetes mellitus, use of statins, atrial fibrillation; pacemaker; thyroid COPD. Methodology: All patients will undergo anthropometric measurements: body mass index, waist circumference and measure the percentage of body fat using bioimpedance it will be collected for blood dosage of leptin, adiponectin, interleukin-6, tumor necrosis factor, glucose, insulin, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride levels after fasting for 12 hours. It will be performed 24 hours Holter; complemented dimensional transthoracic echocardiography with M-mode, pulsed Doppler, tissue and colored; B mode ultrasonography of the carotid arteries . (AU)