Prevalence of Cardiac Arrhythmias and Distal Conduction Disorders in Patients With Chronic Chagas' Disease and Elevated Autoantibodies Against M2 Muscarinic Acetylcholine Receptors

Abstract

Chagas' disease (ChD) is a parasitic disease endemic to regions of Latin America and with an increasingly global reach. Up to 30% of patients with ChD develop severe dilated cardiomyopathy, ventricular arrhythmias, conduction disorders and/or sudden cardiac death. Autoantibodies against M₂ muscarinic acetylcholine receptors (M₂ mAChR) have been implicated in the pathogenesis of ChD. We sought to understand whether there was an association between anti-M₂ mAChR autoantibody titers in patients with chronic ChD and the presence of distal cardiac conduction disorders or cardiac arrhythmias. We conducted a cross-sectional study in 79 patients from Argentina and Bolivia with chronic ChD without evident structural heart disease. Autoantibody titers were measured using indirect enzyme-linked immunosorbent assay. Elevated anti-M₂ mAChR autoantibody titers were associated with the presence of distal conduction disease but not with cardiac arrhythmias. High anti-M₂ mAChR autoantibody levels could assist with identifying early structural heart disease in patients with chronic ChD.