atrial-natriuretic-factor and Chagas-Disease

Chagas' disease (CD) affects around 18 million people in Latin America. To determine the diagnostic and prognostic value of natriuretic peptides in patients with CD, we measured atrial (ANP) and brain natriuretic peptide (BNP), and compared the findings with other dilated cardiomyopathies (DCM).. Blood samples were obtained from 111 CD patients, 62 patients with DCM due to other causes, and 43 gender- and age-matched healthy subjects. The CD and DCM patients were subdivided according to their NYHA classification. Natriuretic peptide concentrations were determined by immunoradiometric assays.. ANP and more pronounced BNP levels were increased in CD and DCM patients in relation to the NYHA class. Circulating BNP concentrations were higher in CD patients in NYHA classes I-II than in the corresponding DCM patients (p = 0.020). Importantly, ANP and BNP were already significantly elevated in CD patients without systolic ventricular dysfunction (p < or = 0.001). In CD patients, both peptides were highly correlated with echocardiographic parameters (p < 10(-14)). Both ANP and BNP had comparable ability to predict death or the necessity for heart transplant (p < 0.0001).. Natriuretic peptide levels can be used as a marker of asymptomatic CD without ventricular dysfunction and thus could be an ideal tool to identify these patients for early therapy.

Topics: Adult; Atrial Natriuretic Factor; Biomarkers; Blood Pressure; Case-Control Studies; Chagas Disease; Echocardiography; Female; Follow-Up Studies; Heart Failure; Heart Transplantation; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Natriuretic Peptide, Brain; Prognosis; Proportional Hazards Models; ROC Curve; Stroke Volume

This study investigated the evolution of plasma atrial natriuretic factor (ANF) in patients in different stages of Chagas' disease and analyzed its usefulness as prognostic factor of the development of myocardial compromise in asymptomatic chagasic patients. Chagas' disease, a determinant of heart failure, is caused by the parasite Trypanosoma cruzi. A total of 21 chagasic patients were studied: 9 in the asymptomatic stage, 6 with conduction defects (CD), and 6 with chronic heart failure (CHF); and 31 controls: 16 healthy, 6 with CD, and 9 with CHF. Plasma ANF radioimmunoassay (RIA) and complementary studies were performed twice for each patient, with an interval period of 12 months. First sample: chagasic patients showed higher ANF levels in the CHF group than in CD and asymptomatic subjects; second sample: the peptide levels were higher in CHF patients than in the asymptomatic group. In non-chagasic CHF patients, ANF levels were higher than in CD patients and controls in both samples. ANF levels were not able to differentiate chagasic asymptomatic and CD patients from healthy subjects and CD controls; meanwhile, chagasic CHF patients showed lower plasma ANF than their controls. Furthermore, ANF is a sensitive marker capable of detecting gradual impairments in cardiac function in all patients studied.

Topics: Animals; Atrial Natriuretic Factor; Biomarkers; Chagas Cardiomyopathy; Chagas Disease; Female; Heart; Humans; Male; Middle Aged; Prognosis; Trypanosoma cruzi

Topics: Acute Disease; Animals; Atrial Natriuretic Factor; Chagas Disease; Heart Atria; Immunohistochemistry; Rats; Rats, Wistar; Time Factors