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. 2015 Apr;17(4):416-23.
doi: 10.1002/ejhf.220. Epub 2015 Feb 10.

Detection of Trypanosoma cruzi DNA in blood by PCR is associated with Chagas cardiomyopathy and disease severity

E C Sabino  1 , A L Ribeiro, T H Lee, C L Oliveira, A B Carneiro-Proietti, A P Antunes, M M Menezes, B M Ianni, V M Salemi, L Nastari, F Fernandes, V Sachdev, D M Carrick, X Deng, D Wright, T T Gonçalez, E L Murphy, B Custer, M P Busch; Chagas Study Group of the NHLBI Retrovirus Epidemiology Donor Study-II, International Component
Collaborators, Affiliations

Detection of Trypanosoma cruzi DNA in blood by PCR is associated with Chagas cardiomyopathy and disease severity

E C Sabino et al. Eur J Heart Fail. 2015 Apr.

Abstract

Background: The significance of detection of Trypanosoma cruzi DNA in blood of antibody-positive patients for risk of development of Chagas heart disease is not well established. The objective of this study was to compare detection of T. cruzi DNA with known clinical and laboratory markers of Chagas cardiomyopathy (CC) severity.

Methods: This is a case-control study nested within a retrospective cohort developed in Brazil to understand the natural history of Chagas disease. The study enrolled 499 T. cruzi seropositive blood donors (SP-BD) and 488 frequency matched seronegative control donors (SN-BD) who had donated between 1996 and 2002, and 101 patients with clinically diagnosed CC. In 2008-2010 all enrolled subjects underwent a health questionnaire, medical examination, electrocardiograms and echocardiograms and polymerase chain reaction (PCR) analyses. A blinded panel of three cardiologists adjudicated the outcome of CC. Trypanosoma cruzi kinetoplast minicircle sequences were amplified by real-time PCR using an assay with a sensitivity of one parasite per 20 mL of blood. All testing was performed on coded samples.

Results: Rates of PCR detection of T. cruzi DNA were significantly (P = 0.003) higher in CC patients and SP-BD diagnosed with CC (79/105 [75.2 %]) compared with SP-BD without CC (143/279 [51.3%]). The presence of parasitaemia was significantly associated with known markers of disease progression such as QRS and QT interval duration, lower left ventricular ejection fraction, higher left ventricular index mass, and elevated troponin and NTpro-BNP levels.

Conclusion: Trypanosoma cruzi PCR positivity is associated with presence and severity of cardiomyopathy, suggesting a direct role of parasite persistence in disease pathogenesis.

Keywords: PCR; Trypanosoma cruzi; cardiomyopathy.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Figure 1
Figure 1
Box plots of ECG variables (QRS and corrected QT intervals). In the left all seropositive subjects were combined according to PCR status. In the right each case group (SP-BD and CC patients) were analyzed separated.
Figure 2
Figure 2
Box plots of ECHO variables (Ejection Fraction and Left Ventricular index mass) In the left all seropositive subjects were combined according to PCR status. In the right each case group (SP-BD and CC patients) were analyzed separated. .
Figure 3
Figure 3
Box plots of Troponin and Pro-BNP level. In the left all seropositive subjects were combined according to PCR status. In the right each case group (SP-BD and CC patients) were analyzed separated.
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References

    1. Marin-Neto JA, Cunha-Neto E, Maciel BC, Simoes MV. Pathogenesis of chronic Chagas heart disease. Circulation. 2007 Mar 6;115(9):1109–1123. - PubMed
    1. Ribeiro AL, Nunes MP, Teixeira MM, Rocha MO. Diagnosis and management of Chagas disease and cardiomyopathy. Nat Rev Cardiol. 2012 Jul 31; - PubMed
    1. Lescure FX, Le Loup G, Freilij H, Develoux M, Paris L, Brutus L, Pialoux G. Chagas disease: changes in knowledge and management. Lancet Infect Dis. 2010 Aug;10(8):556–570. - PubMed
    1. Rassi A, Jr, Rassi A, Marin-Neto JA. Chagas disease. Lancet. 2010 Apr 17;375(9723):1388–1402. - PubMed
    1. Morillo CA. Infection with T. cruzi and Progression to Cardiomyopathy: What is the Evidence and is the Tide Finally Turning Around? Circulation. 2013 Feb 7; - PubMed

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