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Intramyocardial adrenergic activation in chagasic cardiomyopathy and coronary artery disease

Luciano Nastari1, Felix Jose Alvarez Ramires, Vera Maria Cury Salemi

  • 1Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, Rua Doutor Diogo de Faria 1077-62, Vila Clementino, São Paulo-SP, Brazil. lnastari@cardiol.br

Arquivos Brasileiros De Cardiologia
|December 25, 2010
PubMed

Insights

Early cardiac denervation occurs in Chagas' cardiomyopathy (CC) patients with normal ejection fraction, indicated by altered myocardial norepinephrine levels. This finding suggests a distinct pathological pathway compared to coronary artery disease.

Area of Science:

  • Cardiology
  • Neurocardiology
  • Biochemistry

Background:

  • Myocardial norepinephrine alterations are linked to left ventricular impairment.
  • This relationship remains unexamined in Chagas' cardiomyopathy (CC).

Purpose of the Study:

  • To quantify myocardial norepinephrine in CC patients.
  • To compare these levels with coronary artery disease (CAD) patients.
  • To correlate myocardial norepinephrine with left ventricular ejection fraction (LVEF).

Main Methods:

  • Studied 39 CC patients (normal/decreased LVEF) and 17 CAD patients (normal/decreased LVEF).
  • Assessed LVEF using two-dimensional echocardiography.
  • Measured myocardial norepinephrine via high-performance liquid chromatography.

Main Results:

  • CC patients with normal LVEF had significantly lower myocardial norepinephrine (1.3±1.3 pg/μg) than those with dysfunction (6.1±4.2 pg/μg).
  • CAD patients showed similar trends (normal LVEF: 3.3±3.0 pg/μg; dysfunction: 9.8±4.2 pg/μg).
  • Positive correlation between LVEF and myocardial norepinephrine in both CC (r=0.57) and CAD (r=0.69) patients.

Conclusions:

  • Early cardiac denervation is present in CC patients with normal LVEF compared to CAD patients.
  • This suggests a unique early-stage pathology in Chagas' cardiomyopathy.
  • Myocardial norepinephrine levels are significantly altered in CC, even with preserved ejection fraction.
Abstract

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