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Galectin-3 is the sole reliable biomarker for predicting heart disease progression in Chagas disease patients. Other inflammation and fibrosis markers, except troponin, showed increases but lacked prognostic value.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomarker Research
Background:
- Chagas disease, caused by Trypanosoma cruzi, can lead to cardiac complications.
- Early identification of cardiac disease progression is crucial for patient management.
Purpose of the Study:
- To evaluate four biomarkers (galectin-3, NT-proBNP, LOXL2, troponin) as indicators of heart disease progression in Chagas disease patients.
- To determine the prognostic value of these biomarkers over an 11-year period.
Main Methods:
- Longitudinal study of 103 Trypanosoma cruzi-positive individuals with varying disease forms.
- Comparison of biomarker levels (galectin-3, NT-proBNP, LOXL2, troponin) at two time points, 11 years apart.
- Statistical analysis accounting for time between samples and clinical groups.
Main Results:
- Galectin-3 showed a significant difference between groups (P=0.01).
- NT-proBNP and LOXL2 increased in patients progressing to cardiac disease.
- Most biomarkers, except troponin, increased in patients without progression, but galectin-3 was the only significant predictor.
Conclusions:
- Galectin-3 is the only evaluated biomarker with prognostic value for heart disease progression in Chagas disease.
- Further research may refine the use of galectin-3 in managing Chagas disease cardiac complications.
Abstract:
This study evaluated four biomarkers of inflammation or fibrosis as progression indicators for heart disease in patients with Chagas disease. We compared values of these markers at the time of the first sample collection of blood (first time point) and at the time of the last collection of blood (second time point) for 103 individuals positive for Trypanosoma cruzi antibodies. They were split into two clinical groups: 52 individuals with the indeterminate form of the disease at the first time point and 51 controls that already had either cardiac involvement (N = 25) or megaviscera (megaesophagus and/or megacolon; N = 26) at that time. All individuals had an electrocardiogram performed both at the first and second time point (mean time between time points: 11 years). All samples were blind tested for galectin-3, brain natriuretic peptide (NT-proBNP), lysyl oxidase-like protein 2 (LOXL2), and troponin. Differences in concentrations between samples were analyzed using the months between samples as the covariate. This analysis showed that values for all markers, except troponin biomarker had a significative increase at the second time point for the 91 patients without progression. A similar result was obtained for NT-proBNP and LOXL2 with sera from 12 patients that progressed with cardiac disease. The single marker that showed a significative difference between groups (P = 0.01) was galectin-3. We concluded that galectin-3 was the only marker with a prognostic value in relation to the progression or worsening of heart disease in patients with Chagas disease.
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