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Biomarkers assessment in patients with Chagas disease and systemic arterial hypertension
Anderson de Oliveira Vieira1, Gabriel Antônio Nogueira Nascentes2, Ana Carolina de Morais Oliveira3
1Clinical Pathology Service at the Hospital de Clínicas/Ebserh, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais State, Brazil.
Insights
This study found that high-sensitive cardiac troponin T (hs-cTnT) and B-type natriuretic peptide (BNP) can detect cardiac injury in Chagas disease (ChD) patients, even with hypertension. Early detection of myocardial lesions is possible with hs-cTnT.
Area of Science:
- Cardiology
- Public Health
- Biomarker Research
Background:
- Chagas disease (ChD) and systemic arterial hypertension (SAH) are significant public health concerns, contributing to mortality and reduced quality of life.
- Cardiac involvement is a major complication of ChD, often exacerbated by co-existing SAH.
Purpose of the Study:
- To quantify cardiac injury biomarkers in patients with Chagas disease and systemic arterial hypertension.
- To identify the most appropriate biomarkers for detecting cardiac damage in these patient groups.
Main Methods:
- Evaluated cardiac lesion markers including creatine kinase, myoglobin, high-sensitive cardiac troponin T (hs-cTnT), B-type natriuretic peptide (BNP), and C-reactive protein.
- Compared biomarker levels across four groups: hypertensive, ChD-hypertensive, ChD patients, and normotensive volunteers.
- Analyzed biomarker levels in relation to clinical manifestations of ChD (cardiac, cardiodigestive, indeterminate, digestive forms).
Main Results:
- High-sensitive cardiac troponin T (hs-cTnT) and B-type natriuretic peptide (BNP) were identified as the most appropriate biomarkers for cardiac injury.
- Elevated hs-cTnT and BNP levels were primarily observed in patients with Chagas disease, irrespective of hypertension.
- A hs-cTnT cutoff point of < 0.007 ng/mL may facilitate early detection of myocardial lesions.
- Significantly higher hs-cTnT and BNP levels were found in ChD patients with cardiac or cardiodigestive involvement compared to those with indeterminate or digestive forms.
Conclusions:
- BNP and hs-cTnT serve as valuable indirect biomarkers for assessing cardiac damage in Chagas disease.
- These markers are effective for monitoring the cardiac form of ChD, especially in patients with cardiac or cardiodigestive involvement.
- Further research is needed to establish reference values for these biomarkers in Chagas and hypertensive cardiomyopathies.
Abstract:
Chagas disease (ChD) and systemic arterial hypertension (SAH) are two severe comorbidities that lead to mortality and a reduction in people's quality of life, with an impact on public health. The aim of this study was to quantify the biomarkers of cardiac injury in patients with ChD and SAH. Eighty patients were divided into four groups: 20 hypertensive patients, 20 ChD-hypertensive patients, 20 ChD patients, and 20 normotensive volunteers; all of them came from outpatient's public health services. Among the evaluated markers for cardiac lesions (creatine kinase, creatine kinase-MB isoform, myoglobin, high-sensitive cardiac troponin T[hs-cTnT], B-type natriuretic peptide [BNP], and C-reactive protein), hs-cTnT and BNP were the most appropriate. Importantly, our results showed that the cut off point for hs-cTnT could be < 0.007 ng/mL, which could lead to the early detection of myocardial lesions. The BNP and hs-cTnT levels were high only in the ChD and ChD-hypertensive patient groups, suggesting that Chagas' disease may play an important role in the increase of these biomarkers. ChD patients, hypertensive or not, with cardiac or cardiodigestive involvement presented significantly higher values of hs-cTnT (p < 0.001) and BNP (p = 0.001) than ChD patients with indeterminate and digestive forms, which strengthens the validation of these markers for the follow-up of clinical cardiac form of ChD. This study suggests that the BNP and hs-cTnT can be used as possible indirect biomarkers of cardiac damage. In addition, the reference values of these biomarkers in Chagas and hypertensive cardiomyopathies should be better understood with further studies.
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