Rodrigues Angela Braga, da Gama Torres Henrique Oswaldo, Nunes Maria do Carmo Pereira, de Assis Silva Gomes Juliana, Rodrigues Aline Braga, Pinho Laura Lopes Nogueira, Rocha Manoel Otavio, Botoni Fernando Antonio
Postgraduate Course of Infectious Diseases and Tropical Medicine, The Post-Graduate Program in Infectious Diseases and Tropical Medicine (PPG-IMT), School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil.
School of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte 30130-100, MG, Brazil.
Microorganisms. 2022 Aug 9;10(8):1602. doi: 10.3390/microorganisms10081602.
The primary objective was to observe the relationship between serum levels of BNP, Ca-125, C-reactive protein and uric acid as prognostic and functional markers in patients with chronic Chagas cardiomyopathy (CCC). Circulating levels of cytokines: IL-1β, TNFα, IL-10, IL6, IL-8 and IL-12 were determined and investigated regarding their association with hemodynamic parameters, clinical signs of heart failure and outcome. Chagas is still a neglected disease that affects numerous individuals, many of them in their most productive years. CCC with left ventricular dysfunction is the most severe presentation of Chagas Disease. BNP is a well-recognized prognostic and clinical biomarker, not only in chronic heart failure patients but also in patients with CCC. Previous studies have shown Ca-125, C-reactive protein, and uric acid to be potentially good prognostic markers in heart failure (HF). Fifty patients with left ventricular fraction less (LVEF) than 55% were selected and followed for a mean period of 18 ± 8.3 months. Patient's mean age was 43.42 ± 10.3 years (32 male), their BNP was 293 (160-530) pg/mL, Ca-125 8.5 (5.5-16.75) U/mL, uric acid 6.2 ± 2 mg/dL, and C- reactive protein 4.5 (4.5-7.3) mg/L. Patients who had LVEF less than 35% had higher BNP ( = 0.0023), Ca-125 ( = 0.027) and uric acid ( = 0.01) serum levels. Patients who died also showed higher BNP ( = 0.01), uric acid ( = 0.05) and a trend towards higher Ca-125 serum levels ( = 0.056). All markers: BNP, Ca-125, uric acid and C-reactive had good predictability of death in Cox-regression univariate analysis, however, not on the final multivariate model. Of the inflammatory cytokines, IL-8 and IL-12 showed a relation to LVEF of less than 35%. IL-12 was related to adverse cardiovascular events and non-survival. IL-1β was a good predictor of mortality in the final Cox regression model. Determination of Ca-125, uric acid levels and C-reactive protein may add useful clinical and prognostic information and may help clinical decision making for patients with CCC.
主要目的是观察慢性恰加斯心肌病（CCC）患者血清中脑钠肽（BNP）、癌抗原125（Ca-125）、C反应蛋白和尿酸水平之间的关系，将其作为预后和功能标志物。测定并研究了循环细胞因子白细胞介素-1β（IL-1β）、肿瘤坏死因子α（TNFα）、白细胞介素-10（IL-10）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和白细胞介素-12（IL-12）的水平，并探讨它们与血流动力学参数、心力衰竭临床体征及预后的相关性。恰加斯病仍是一种被忽视的疾病，影响着众多个体，其中许多人正处于最具生产力的年龄段。伴有左心室功能障碍的CCC是恰加斯病最严重的表现形式。BNP不仅是慢性心力衰竭患者，也是CCC患者公认的预后和临床生物标志物。先前的研究表明，Ca-125、C反应蛋白和尿酸可能是心力衰竭（HF）潜在的良好预后标志物。选取50例左心室射血分数（LVEF）低于55%的患者，平均随访18±8.3个月。患者平均年龄为43.42±10.3岁（男性32例），其BNP为293（160 - 530）pg/mL，Ca-125为8.5（5.5 - 16.75）U/mL，尿酸为6.2±2mg/dL，C反应蛋白为4.5（4.5 - 7.3）mg/L。LVEF低于35%的患者血清BNP（P = 0.0023）、Ca-125（P = 0.027）和尿酸（P = 0.01）水平更高。死亡患者的血清BNP（P = 0.01）、尿酸（P = 0.05）水平也更高，且Ca-125血清水平有升高趋势（P = 0.056）。在Cox回归单因素分析中，所有标志物：BNP、Ca-125、尿酸和C反应蛋白对死亡均有良好的预测能力，但在最终的多变量模型中并非如此。在炎性细胞因子中，IL-8和IL-12与LVEF低于35%有关。IL-12与不良心血管事件和非生存相关。在最终的Cox回归模型中，IL-1β是死亡率的良好预测指标。测定Ca-125、尿酸水平和C反应蛋白可能会提供有用的临床和预后信息，并有助于CCC患者的临床决策。
