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ADENOSINE DEAMINASE ACTIVITY AND SERUM C-REACTIVE PROTEIN AS PROGNOSTIC MARKERS OF CHAGAS DISEASE SEVERITY.

Bravo-Tobar ID, Nello-Pérez C, Fernández A, Mogollón N, Pérez MC, Verde J, Concepción JL, Rodriguez-Bonfante C, Bonfante-Cabarcas R - Rev. Inst. Med. Trop. Sao Paulo (2015 Sep-Oct)

Bottom Line: The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases.Finally, CRP was positively correlated with ADA.In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.

View Article: PubMed Central - PubMed

Affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.

ABSTRACT
Chagas disease is a public health problem worldwide. The availability of diagnostic tools to predict the development of chronic Chagas cardiomyopathy is crucial to reduce morbidity and mortality. Here we analyze the prognostic value of adenosine deaminase serum activity (ADA) and C-reactive protein serum levels (CRP) in chagasic individuals. One hundred and ten individuals, 28 healthy and 82 chagasic patients were divided according to disease severity in phase I (n = 35), II (n = 29), and III (n = 18). A complete medical history, 12-lead electrocardiogram, chest X-ray, and M-mode echocardiogram were performed on each individual. Diagnosis of Chagas disease was confirmed by ELISA and MABA using recombinant antigens; ADA was determined spectrophotometrically and CRP by ELISA. The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases. Also, CRP and ADA were positively correlated with echocardiographic parameters of cardiac remodeling and with electrocardiographic abnormalities, and negatively with ejection fraction. CRP and ADA were higher in patients with cardiothoracic index ≥ 50%, while ADA was higher in patients with ventricular repolarization disturbances. Finally, CRP was positively correlated with ADA. In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.

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Related in: MedlinePlus

- Serum markers and cardiothoracic index (CTI). Values of serum CRP levels (left panel) and serum ADA activity (right panel) are compared between patients with CTI less than 50% and patients with CTI higher than 50%. Observe that in both cases the levels of serum markers are significantly (* p < 0.05) elevated in patients with CTI > 50%.
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f05: - Serum markers and cardiothoracic index (CTI). Values of serum CRP levels (left panel) and serum ADA activity (right panel) are compared between patients with CTI less than 50% and patients with CTI higher than 50%. Observe that in both cases the levels of serum markers are significantly (* p < 0.05) elevated in patients with CTI > 50%.

Mentions: Serum levels of C-reactive protein in the sample were 1.64 ± 0.36 mg/L (n = 28) for controls and 4.27 ± 0.73 mg/L (n = 82) for chagasic patients, being the difference statistically significant (p < 0.05). By analyzing the values in relation to clinical stages of the disease, we observed that serum levels increased linearly and significantly, as the disease progresses to more advanced stages (see Fig. 1). Serum levels of C-reactive protein were negatively correlated with left ventricle ejection fraction, indicating that it could be a marker of ventricular function (Fig. 3). In contrast, serum levels of C-reactive protein were positively correlated with systolic and diastolic left ventricular diameter, with left ventricular mass, and left ventricular mass index; the same results were obtained regarding the diastolic diameter of the right ventricle, indicating that CRP is a marker of cardiac remodeling (Table 4 and Fig. 4). This finding was confirmed by observing that CRP levels were significantly (p < 0.05) higher in patients with ≥ 50% cardiothoracic index (5.56 ± 1.25) when compared with patients with a cardiothoracic index < 50% (2.63 ± 0.54) (Fig. 5).


ADENOSINE DEAMINASE ACTIVITY AND SERUM C-REACTIVE PROTEIN AS PROGNOSTIC MARKERS OF CHAGAS DISEASE SEVERITY.

Bravo-Tobar ID, Nello-Pérez C, Fernández A, Mogollón N, Pérez MC, Verde J, Concepción JL, Rodriguez-Bonfante C, Bonfante-Cabarcas R - Rev. Inst. Med. Trop. Sao Paulo (2015 Sep-Oct)

- Serum markers and cardiothoracic index (CTI). Values of serum CRP levels (left panel) and serum ADA activity (right panel) are compared between patients with CTI less than 50% and patients with CTI higher than 50%. Observe that in both cases the levels of serum markers are significantly (* p < 0.05) elevated in patients with CTI > 50%.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660446&req=5

f05: - Serum markers and cardiothoracic index (CTI). Values of serum CRP levels (left panel) and serum ADA activity (right panel) are compared between patients with CTI less than 50% and patients with CTI higher than 50%. Observe that in both cases the levels of serum markers are significantly (* p < 0.05) elevated in patients with CTI > 50%.
Mentions: Serum levels of C-reactive protein in the sample were 1.64 ± 0.36 mg/L (n = 28) for controls and 4.27 ± 0.73 mg/L (n = 82) for chagasic patients, being the difference statistically significant (p < 0.05). By analyzing the values in relation to clinical stages of the disease, we observed that serum levels increased linearly and significantly, as the disease progresses to more advanced stages (see Fig. 1). Serum levels of C-reactive protein were negatively correlated with left ventricle ejection fraction, indicating that it could be a marker of ventricular function (Fig. 3). In contrast, serum levels of C-reactive protein were positively correlated with systolic and diastolic left ventricular diameter, with left ventricular mass, and left ventricular mass index; the same results were obtained regarding the diastolic diameter of the right ventricle, indicating that CRP is a marker of cardiac remodeling (Table 4 and Fig. 4). This finding was confirmed by observing that CRP levels were significantly (p < 0.05) higher in patients with ≥ 50% cardiothoracic index (5.56 ± 1.25) when compared with patients with a cardiothoracic index < 50% (2.63 ± 0.54) (Fig. 5).

Bottom Line: The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases.Finally, CRP was positively correlated with ADA.In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.

View Article: PubMed Central - PubMed

Affiliation: Universidade Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela.

ABSTRACT
Chagas disease is a public health problem worldwide. The availability of diagnostic tools to predict the development of chronic Chagas cardiomyopathy is crucial to reduce morbidity and mortality. Here we analyze the prognostic value of adenosine deaminase serum activity (ADA) and C-reactive protein serum levels (CRP) in chagasic individuals. One hundred and ten individuals, 28 healthy and 82 chagasic patients were divided according to disease severity in phase I (n = 35), II (n = 29), and III (n = 18). A complete medical history, 12-lead electrocardiogram, chest X-ray, and M-mode echocardiogram were performed on each individual. Diagnosis of Chagas disease was confirmed by ELISA and MABA using recombinant antigens; ADA was determined spectrophotometrically and CRP by ELISA. The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases. Also, CRP and ADA were positively correlated with echocardiographic parameters of cardiac remodeling and with electrocardiographic abnormalities, and negatively with ejection fraction. CRP and ADA were higher in patients with cardiothoracic index ≥ 50%, while ADA was higher in patients with ventricular repolarization disturbances. Finally, CRP was positively correlated with ADA. In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.

Show MeSH
Related in: MedlinePlus