Chronic American trypanosomiasis: parasite persistence in endomyocardial biopsies is associated with high-grade myocarditis

Autor(es)

Benvenuti, L. A. ^[1] ; Roggerio, A. ^[1] ; Freitas, H. F. G. ^[1] ; Mansur, A. J. ^[1] ; Fiorelli, A. ^[1] ; Higuchi, M. L. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Heart Inst InCor, BR-05403000 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY; v. 102, n. 6, p. 481-487, SEP 2008.
• Citações Web of Science: 46

Resumo

Myocyte diameter, fractional area of collagen, intensity of myocarditis and parasite persistence (explored by immunohistochemistry and PCR) were evaluated in serial sections of endomyocardial biopsies from 29 outpatients with chronic chagasic cardiopathy. The patients, 25 males and four females with a mean (S.D.) age of 43 (9) years, were subsequently followed up for 3-2861 days (median=369 days). During this follow-up, 16 (55%) of the patients died. The biopsies revealed myocarditis in 25 (86%) of the patients and high-grade myocarditis in 14 (56%). Although immunohistochemistry failed to demonstrate Trypanosoma cruzi antigens in any of the samples, five (33%) of the 15 biopsies successfully tested in the PCR-based assay for T. cruzi DNA were found positive, indicating parasite persistence. There was a significant positive association between myocardial parasite persistence and high-grade myocarditis (P= 0.014); five (71%,) of the seven endomyocardial biopsies with high-grade myocarditis that were successfully tested in the PCR assays showed persistent T. cruzi DNA. The survival time of the patients was not, however, found to be significantly associated with myocardial parasite persistence, any of the morphometric measurements taken, or the presence or intensity of myocarditis. (AU)

• Processo FAPESP: 05/56469-0 - Estudo da associação entre características histopatológicas do miocárdio e o tempo de sobrevida de pacientes portadores de cardiomiopatia chagásica crônica, com ênfase na questão da persistência parasitária no miocárdio
• Beneficiário: Luiz Alberto Benvenuti
• Modalidade de apoio: Auxílio à Pesquisa - Regular