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Progressive Chagas' cardiomyopathy is associated with low selenium levels
Maria Teresa Rivera1, Andréa P de Souza, Alejandro Marcel Hasslocher-Moreno
1Departamento de Ultra-estrutura e Biologia Celular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
Insights
Selenium (Se) deficiency is linked to heart dysfunction in Chagas disease patients. Lower Se levels in symptomatic patients suggest it may be a marker for Trypanosoma cruzi infection progression.
Area of Science:
- Cardiology
- Nutritional Science
- Infectious Diseases
Background:
- Selenium (Se) deficiency is associated with certain cardiomyopathies.
- Chagas' disease, caused by Trypanosoma cruzi, can lead to cardiac complications.
Purpose of the Study:
- To investigate selenium status in patients with chronic Chagas' disease.
- To determine if selenium levels correlate with disease severity and progression.
Main Methods:
- Selenium levels were measured in 170 patients from two Brazilian regions.
- Patients were stratified into asymptomatic (IND, CARDa) and symptomatic (CARDb) groups, with healthy adults (HA) as controls.
- Echocardiography assessed ventricular ejection fraction; glutathione peroxidase activity and thyrotropin levels were also measured.
Main Results:
- Selenium levels were significantly lower in symptomatic cardiac patients (CARDb) compared to healthy adults and other patient groups.
- Selenium levels showed a positive correlation with ventricular ejection fraction.
- Low selenium was observed in chagasic patients with digestive megasyndromes.
Conclusions:
- Decreased selenium levels in Chagas' disease patients may serve as a biological marker for Trypanosoma cruzi infection.
- Reduced selenium is associated with the progression of Chagas' disease pathology, particularly cardiac dysfunction.
Abstract:
Selenium (Se) deficiency is linked with some cardiomyopathies. Its status was determined in 170 patients with chronic Chagas' disease from 2 Brazilian regions (Rio de Janeiro and Belo Horizonte), clinically stratified into groups as follows: indeterminate or asymptomatic (IND); cardiac asymptomatic (CARDa); cardiac symptomatic with moderate to severe heart dysfunction (CARDb); and healthy adults (HA), used for comparison. In most HA, Se levels were normal, excluding an overall Se deficiency. Se was significantly lower in CARDb than in HA, IND, or CARDa patients. This was not associated with a concomitant decrease in activity of glutathione peroxidase. Thyrotropin was normal, excluding iodine deficiency. Se correlated positive and significantly with ventricular ejection fraction (assessed via echocardiography). Asymptomatic children with acute Chagas' disease had normal Se as well as 5 noninfectious cases of cardiomyopathy. Low Se was found in 6 of 10 chagasic patients with digestive megasyndromes. Thus, the decrease in Se in chagasic patients seems to be a biological marker for Trypanosoma cruzi infection and related to the progression of pathology.