Dysregulation of Autonomic Nervous System in Chagas' Heart Disease Is Associated with Altered Adipocytokines Levels

Author(s)

Barbosa-Ferreira, Joao Marcos ^[1] ; Mady, Charles ^[1] ; Ianni, Barbara Maria ^[1] ; Lopes, Heno Ferreira ^{[2, 3]} ; Alvarez Ramires, Felix Jose ^[1] ; Cury Salemi, Vera Maria ^[1] ; Grupi, Cesar Jose ^[4] ; Hachul, Denise Tessariol ^[5] ; Fernandes, Fabio ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Med, Hosp Clin, Cardiomyopathy Unit, Heart Inst InCor, Sao Paulo - Brazil

^[2] Univ Nove Julho UNINOVE, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Hosp Clin, Hypertens Unit, Heart Inst InCor, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Fac Med, Hosp Clin, Heart Inst InCor, Electrocardiol Unit, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Fac Med, Hosp Clin, Clin Arrhythmia Unit, Heart Inst InCor, Sao Paulo - Brazil

• Document type: Journal article
• Source: PLoS One; v. 10, n. 7 JUL 6 2015.
• Web of Science Citations: 7

Abstract

Background Chagas disease (CD) induces autonomic dysfunction and inflammatory activity, which may promote metabolic abnormalities. We studied metabolism and his correlation with Autonomic Nervous System (ANS) and inflammation in CD. Methods and Results Sixty subjects were divided into 4 groups: control group (CG), IF (indeterminate form) group; ECG group (ECG abnormalities and normal left ventricular systolic function), and LVD group (left ventricular sistolic dysfunction). Levels of adiponectin, leptin, insulin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were assayed in serum samples by ELISA. ANS was assessed by heart rate variability in frequency domain in 24-hour Holter and postural tilt test (rest and orthostatic position). High frequency (HFr) component values were used to estimate parasympathetic activity and low frequency (LFr) component, sympathetic activity. Analyzes were made of the correlations of each of the metabolic parameters (leptin and adiponectin) with the inflammatory cytokines (interleukin-6 and TNF-alpha) and with the ANS assessment measurements. No significant differences were observed in leptin and insulin levels. Adiponectin was higher in ECG and LVD groups: {[}CG = 4766.5 (5529.5), IF = 4003.5 (2482.5), ECG = 8376.5 (8388.5), LVD = 8798 (4188.0) ng/mL, p<0.001)]. IL-6 and TNF-alpha were higher in LVD group: {[}IL-6: CG = 1.85 (6.41); IF = 1.58 (1.91); ECG = 1.0 (1.57); LVD= 31.44 (72.19) pg/ml; p = 0.001. TNF-alpha: CG = 22.57 (88.2); IF = 19.31 (33.16); ECG = 12.45 (3.07); LVD = 75.15 (278.57) pg/ml; p = 0.04]. Adiponectin levels had a positive association with the HFr component (r = 0.539; p = 0.038) and an inverse association with the LFr component (r = -0.539; p = 0.038) in ECG group. Leptin levels had a negative association with the HFr component (r = -0.632; p = 0.011) and a positive association with the LFr component (r = 0.632; p = 0.011) in LVD group. Conclusions We found increased adiponectin levels in Chagas' heart disease with systolic dysfunction and in patients with ECG abnormalities and normal systolic function at rest. Adipocytokines levels (adiponectin and leptin) were associated with ANS parameters in Chagas' heart disease. (AU)

• FAPESP's process: 09/16887-9 - Inflammatory and metabolic mediators in different forms of Chagas disease: correlation with autonomic disfunction
• Grantee: Fabio Fernandes
• Support Opportunities: Regular Research Grants