Accumulation of brown adipose tissue in patients with Chagas heart disease.

Brown adipose tissue (BAT) is an important source of non-shivering thermogenesis. Increased BAT amounts have been reported to occur in association with several diseases, including congestive heart failure. The objective of the present study was to determine whether BAT accumulation occurs in patients with Chagas disease. Histological sections of peri-adrenal tissue obtained at autopsy from 259 patients were examined. Of these patients, 58 had the digestive form of Chagas disease, 50 had the cardiac form without heart failure and 201 had the cardiac form with heart failure. All cases were investigated in terms of nutritional status and classified as malnourished, normotrophic or obese according to the Quetelet index. The results showed no correlation between BAT and the patients' nutritional status, and more BAT accumulation in patients with the cardiac form of Chagas disease compared to patients with the digestive form. Similarly, a history of heart failure was correlated with greater BAT accumulation. On the basis of the present data and of information reported in the literature, we propose that chronic hypoxia may be the cause of BAT accumulation in Chagas disease patients with heart failure.