SERGIO SALLES Xavier - Academia.edu (original) (raw)

Papers by SERGIO SALLES Xavier

Research paper thumbnail of Epidemiological-clinical profile and mortality in patients coinfected with Trypanosoma cruzi/HIV: experience from a Brazilian reference center

Revista Da Sociedade Brasileira De Medicina Tropical, 2022

Research paper thumbnail of Analysis of Three-Dimensional Scar Architecture and Conducting Channels by High-Resolution Contrast-Enhanced Cardiac Magnetic Resonance Imaging in Chagas Heart Disease

Revista da Sociedade Brasileira de Medicina Tropical

Background: We aimed to describe the morphology of the border zone of viable myocardium surrounde... more Background: We aimed to describe the morphology of the border zone of viable myocardium surrounded by scarring in patients with Chagas heart disease and study their association with clinical events. Methods: Adult patients with Chagas heart disease (n=22; 55% females; 65.5 years, SD 10.1) were included. Patients underwent high-resolution contrast-enhanced cardiac magnetic resonance using myocardial delayed enhancement with postprocessing analysis to identify the core scar area and border zone channels number, mass, and length. The association between border zone channel parameters and the combined endpoint (cardiovascular mortality or internal cardiac defibrillator implantation) was tested by multivariable Cox proportional hazard regression analyses. The significance level was set at 0.05. Data are presented as the mean (standard deviation [SD]) or median (interquartile range). Results: A total of 44 border zone channels (1[1-3] per patient) were identified. The border zone channel mass per patient was 1.25 (0.48-4.39) g, and the extension in layers of the border zone channels per patient was 2.4 (1.0-4.25). Most border zone channels were identified in the midwall location. Six patients presented the studied end-point during a mean follow-up of 4.9 years (SD 1.6). Border zone channel extension in layers was associated with the studied end-point independent from left ventricular ejection fraction or fibrosis mass (HR=2.03; 95% CI 1.15-3.60). Conclusions: High-resolution contrast-enhanced cardiac magnetic resonance can identify border zone channels in patients with Chagas heart disease. Moreover, border zone channel extension was independently associated with clinical events.

Research paper thumbnail of Letters to the Editor: Indeterminate form of Chagas Disease: some immunological insights

Revista da Sociedade Brasileira de Medicina Tropical

Research paper thumbnail of Chagas disease mortality during the coronavirus disease 2019 pandemic: A Brazilian referral center experience

Revista da Sociedade Brasileira de Medicina Tropical, 2022

All authors had full access to all the data in the study and take responsibility for the integrit... more All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. AMH-M was responsible for the study concept. AMH-M, RMS, GMSS, SSX, ASS, ARC, FSNSM, and MFFM were responsible for acquisition, analysis or interpretation of data. AMH-M was responsible for drafting the manuscript. RMS and MFFM were responsible for reviewing the manuscript. MFFM was responsible for statistical analysis. All authors have read and agreed to the published version of the manuscript.

Research paper thumbnail of Indeterminate form of Chagas disease: historical, conceptual, clinical, and prognostic aspects

Revista da Sociedade Brasileira de Medicina Tropical, 2021

Research paper thumbnail of Benznidazole decreases the risk of chronic Chagas disease progression and cardiovascular events: A long-term follow up study

Research paper thumbnail of Fibrose Cardíaca e Mudanças Evolutivas na Função Ventricular Esquerda em Pacientes com Cardiopatia Chagásica Crônica

Arquivos Brasileiros de Cardiologia, 2021

Research paper thumbnail of Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort

Tropical Medicine and Infectious Disease, 2020

Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to ... more Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to develop the cardiac form. However, the actual rate of progression to the cardiac form is still unknown. Methods: In total, 550 patients with the indeterminate CD form were followed by means of annual electrocardiogram at our outpatient clinic. The studied endpoint was progression to cardiac form defined by the appearance of electrocardiographic changes typical of CD. The progression rate was calculated as the cumulative progression rate and the incidence progression rate per 100 patient years. Results: Thirty-seven patients progressed to the CD cardiac form within a mean of 73 ± 48 months of follow-up, which resulted in a 6.9% cumulative progression rate and incidence rate of 1.48 cases/100 patient years. Patients who progressed were older (mean age 47.8 ± 12.2 years), had a higher prevalence of associated heart diseases (p < 0.0001), positive xenodiagnosis (p = 0.007), and were born ...

Research paper thumbnail of Case Report: Malignant Ventricular Arrhythmias Mimicking Acute Coronary Syndrome in Chagas Disease

The American Journal of Tropical Medicine and Hygiene, 2020

Research paper thumbnail of A protocol update for the Selenium Treatment and Chagasic Cardiomyopathy (STCC) trial

Trials, Jan 19, 2018

Several studies evaluating clinical forms of chronic Chagas disease show that about one-third of ... more Several studies evaluating clinical forms of chronic Chagas disease show that about one-third of patients present cardiac involvement. Heart failure, sudden death and cardioembolic stroke are the main mechanisms of death in Chagas heart disease. The impact of specific etiologic treatment on the prognosis of patients with chronic Chagas heart disease is very limited regardless of the presence or absence of heart failure. Patients with symptomatic Chagas heart disease present serum selenium (Se) levels lower than patients without Chagas heart disease. Moreover, Se supplementation in animal models showed promising results. The aim of this trial is to estimate the effect of Se treatment on prevention of heart disease progression in patients with Chagas cardiomyopathy. However, we had to introduce some protocol modifications in order to keep trial feasibility, as follows: the primary outcome was restricted to left ventricular ejection fraction as a continuous variable, excluding disease ...

Research paper thumbnail of Myocardial Edema without Fibrosis by Magnetic Resonance T2 Mapping in Acute Chagas' Myocarditis

Arquivos Brasileiros de Cardiologia, 2017

Research paper thumbnail of Progressive Chagas' cardiomyopathy is associated with low selenium levels

The American Journal of Tropical Medicine and Hygiene, 2002

Selenium (Se) deficiency is linked with some cardiomyopathies. Its status was determined in 170 p... more Selenium (Se) deficiency is linked with some cardiomyopathies. Its status was determined in 170 patients with chronic Chagas' disease from 2 Brazilian regions (Rio de Janeiro and Belo Horizonte), clinically stratified into groups as follows: indeterminate or asymptomatic (IND); cardiac asymptomatic (CARDa); cardiac symptomatic with moderate to severe heart dysfunction (CARDb); and healthy adults (HA), used for comparison. In most HA, Se levels were normal, excluding an overall Se deficiency. Se was significantly lower in CARDb than in HA, IND, or CARDa patients. This was not associated with a concomitant decrease in activity of glutathione peroxidase. Thyrotropin was normal, excluding iodine deficiency. Se correlated positive and significantly with ventricular ejection fraction (assessed via echocardiography). Asymptomatic children with acute Chagas' disease had normal Se as well as 5 noninfectious cases of cardiomyopathy. Low Se was found in 6 of 10 chagasic patients with digestive megasyndromes. Thus, the decrease in Se in chagasic patients seems to be a biological marker for Trypanosoma cruzi infection and related to the progression of pathology.

Research paper thumbnail of Evolution of anti-Trypanosoma cruzi antibody production in patients with chronic Chagas disease: Correlation between antibody titers and development of cardiac disease severity

PLoS neglected tropical diseases, 2017

Chagas disease is one of the most important endemic infections in Latin America affecting around ... more Chagas disease is one of the most important endemic infections in Latin America affecting around 6-7 million people. About 30-50% of patients develop the cardiac form of the disease, which can lead to severe cardiac dysfunction and death. In this scenario, the identification of immunological markers of disease progression would be a valuable tool for early treatment and reduction of death rates. In this observational study, the production of anti-Trypanosoma cruzi antibodies through a retrospective longitudinal follow-up in chronic Chagas disease patients´ cohort and its correlation with disease progression and heart commitment was evaluated. Strong inverse correlation (ρ = -0.6375, p = 0.0005) between anti-T. cruzi IgG1 titers and left ventricular ejection fraction (LVEF) in chronic Chagas cardiomyopathy (CCC) patients were observed after disease progression. Elevated levels of anti-T. cruzi IgG3 titers were detected in all T. cruzi-infected patients, indicating a lack of correlati...

Research paper thumbnail of Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

Revista da Sociedade Brasileira de Medicina Tropical, 2016

Introduction: With the globalization of Chagas disease, unexperienced health care providers may h... more Introduction: With the globalization of Chagas disease, unexperienced health care providers may have difficulties in identifying which patients should be examined for this condition. This study aimed to develop and validate a diagnostic clinical prediction model for chronic Chagas disease. Methods: This diagnostic cohort study included consecutive volunteers suspected to have chronic Chagas disease. The clinical information was blindly compared to serological tests results, and a logistic regression model was fit and validated. Results: The development cohort included 602 patients, and the validation cohort included 138 patients. The Chagas disease prevalence was 19.9%. Sex, age, referral from blood bank, history of living in a rural area, recognizing the kissing bug, systemic hypertension, number of siblings with Chagas disease, number of relatives with a history of stroke, ECG with low voltage, anterosuperior divisional block, pathologic Q wave, right bundle branch block, and any kind of extrasystole were included in the final model. Calibration and discrimination in the development and validation cohorts (ROC AUC 0.904 and 0.912, respectively) were good. Sensitivity and specificity analyses showed that specificity reaches at least 95% above the predicted 43% risk, while sensitivity is at least 95% below the predicted 7% risk. Net benefit decision curves favor the model across all thresholds. Conclusions: A nomogram and an online calculator (available at http://shiny.ipec.fiocruz.br:3838/ pedrobrasil/chronic_chagas_disease_prediction/) were developed to aid in individual risk estimation.

Research paper thumbnail of Cardiopatia chagásica crônica no Rio Negro, Estado do Amazonas. Relato de três novos casos autóctones, comprovados por exames sorológicos, clínicos, radiográficos do tórax, eletro e ecocardiográficos

Revista da Sociedade Brasileira de Medicina Tropical, 2006

São relatados três novos casos de miocardiopatia chagásica crônica em pacientes autóctones do Rio... more São relatados três novos casos de miocardiopatia chagásica crônica em pacientes autóctones do Rio Negro, Estado do Amazonas, confirmados por sorologia (imunofluorescência, ELISA e Western-blot para infecção pelo Trypanosoma cruzi) e por exames clínicos, radiográficos, eletro e ecocardiográficos. Os pacientes nasceram e sempre viveram na região do Rio Negro, tendo sido picados numerosas vezes por triatomíneos silvestres em piaçabais da área. O quadro clínico foi de insuficiência cardíaca congestiva e distúrbio da condução intraventricular nos três casos (BRD com HBAE em dois casos e BRE de terceiro grau em um caso), extra-sístoles ventriculares polimórficas em dois casos e alteração primária da repolarização ventricular em um deles. A avaliação ecocardiográfica revelou importante aumento dos diâmetros cavitários do VE, com fração da ejeção < 36% e padrão segmentar de acometimento miocárdico, incluindo aneurisma apical e acinesia ínfero-posterior nos três pacientes. Estes são os pr...

Research paper thumbnail of Morbidade da doença de Chagas em pacientes autóctones da microrregião do Rio Negro, Estado do Amazonas

Revista da Sociedade Brasileira de Medicina Tropical, 2010

INTRODUÇÃO: Foi realizado um estudo soroepidemiológico e clínico em 152 indivíduos residentes no ... more INTRODUÇÃO: Foi realizado um estudo soroepidemiológico e clínico em 152 indivíduos residentes no município de Barcelos, Estado do Amazonas. Avaliou-se a soroprevalência da infecção chagásica e a morbidade da doença de Chagas. MÉTODOS: Os testes sorológicos foram a imunofluorescência indireta, ELISA convencional e recombinante e o Tesa-blot. Foram considerados soropositivos 38 pacientes, duvidosos 31 e soronegativos negativos 83. Os 38 casos soropositivos foram pareados com 38 controles soronegativos da mesma idade, sexo e submetidos à avaliação epidemiológica, clínica, eletro e ecocardiográfica, sendo que, 29 pares fizeram exame radiológico do esôfago. RESULTADOS: A soropositividade foi 19,9 vezes mais frequente nos trabalhadores do extrativismo em geral e 10,4 vezes mais frequente no extrativismo da piaçaba. Aplicou-se o teste de reconhecimento com o vetor local do gênero Rhodnius e 86,7% dos pacientes soropositivos o reconheceram, enquanto somente 34,2% dos soronegativos o fizeram...

Research paper thumbnail of Electrocardiographic Ventricular Repolarization Parameters in Chronic Chagas' Disease as Predictors of Asymptomatic Left Ventricular Systolic Dysfunction

Pacing and Clinical Electrophysiology, 2003

Electrocardiographic repolarization parameters are potential markers of arrhythmogenic risk and h... more Electrocardiographic repolarization parameters are potential markers of arrhythmogenic risk and have not been evaluated in Chagas' disease. The aim of this report was to investigate their associations with LV systolic function assessed by two‐dimensional echocardiography. In a cross‐sectional study involving 738 adult outpatients in the chronic phase of Chagas' disease, maximal QTc and T wave peak‐to‐end (TpTe) intervals, and QT, QTapex (QTa), JT and TpTe interval dispersions, and variation coefficients were measured and calculated from 12‐lead standard ECGs. Clinical, radiological, ECG, and echocardiographic data were recorded. In bivariate statistical analysis, all repolarization parameters were significantly increased in patients with moderate or severe LV systolic dysfunction, and these patients showed more clinical, radiologic, and ECG abnormalities. Receiver operating characteristic curve analysis demonstrated that isolatedly QTd had the best predictive performance for...

Research paper thumbnail of Implication of Transforming Growth Factor–β1 in Chagas Disease Myocardiopathy

The Journal of Infectious Diseases, 2002

Research paper thumbnail of Biodistribution of bone marrow mononuclear cells in chronic chagasic cardiomyopathy after intracoronary injection

International Journal of Cardiology, 2011

BackgroundAnimal and human clinical studies have indicated that bone marrow (BM) mononuclear cell... more BackgroundAnimal and human clinical studies have indicated that bone marrow (BM) mononuclear cell (MNC) therapy for Chagasic Cardiomyopathy (ChC) is feasible, safe and potentially efficacious. Nevertheless, little is known about the retention of these cells after intracoronary (IC) infusion.

Research paper thumbnail of Dealing with initial inconclusive serological results for chronic Chagas disease in clinical practice

European Journal of Clinical Microbiology & Infectious Diseases, 2011

Research paper thumbnail of Epidemiological-clinical profile and mortality in patients coinfected with Trypanosoma cruzi/HIV: experience from a Brazilian reference center

Revista Da Sociedade Brasileira De Medicina Tropical, 2022

Research paper thumbnail of Analysis of Three-Dimensional Scar Architecture and Conducting Channels by High-Resolution Contrast-Enhanced Cardiac Magnetic Resonance Imaging in Chagas Heart Disease

Revista da Sociedade Brasileira de Medicina Tropical

Background: We aimed to describe the morphology of the border zone of viable myocardium surrounde... more Background: We aimed to describe the morphology of the border zone of viable myocardium surrounded by scarring in patients with Chagas heart disease and study their association with clinical events. Methods: Adult patients with Chagas heart disease (n=22; 55% females; 65.5 years, SD 10.1) were included. Patients underwent high-resolution contrast-enhanced cardiac magnetic resonance using myocardial delayed enhancement with postprocessing analysis to identify the core scar area and border zone channels number, mass, and length. The association between border zone channel parameters and the combined endpoint (cardiovascular mortality or internal cardiac defibrillator implantation) was tested by multivariable Cox proportional hazard regression analyses. The significance level was set at 0.05. Data are presented as the mean (standard deviation [SD]) or median (interquartile range). Results: A total of 44 border zone channels (1[1-3] per patient) were identified. The border zone channel mass per patient was 1.25 (0.48-4.39) g, and the extension in layers of the border zone channels per patient was 2.4 (1.0-4.25). Most border zone channels were identified in the midwall location. Six patients presented the studied end-point during a mean follow-up of 4.9 years (SD 1.6). Border zone channel extension in layers was associated with the studied end-point independent from left ventricular ejection fraction or fibrosis mass (HR=2.03; 95% CI 1.15-3.60). Conclusions: High-resolution contrast-enhanced cardiac magnetic resonance can identify border zone channels in patients with Chagas heart disease. Moreover, border zone channel extension was independently associated with clinical events.

Research paper thumbnail of Letters to the Editor: Indeterminate form of Chagas Disease: some immunological insights

Revista da Sociedade Brasileira de Medicina Tropical

Research paper thumbnail of Chagas disease mortality during the coronavirus disease 2019 pandemic: A Brazilian referral center experience

Revista da Sociedade Brasileira de Medicina Tropical, 2022

All authors had full access to all the data in the study and take responsibility for the integrit... more All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. AMH-M was responsible for the study concept. AMH-M, RMS, GMSS, SSX, ASS, ARC, FSNSM, and MFFM were responsible for acquisition, analysis or interpretation of data. AMH-M was responsible for drafting the manuscript. RMS and MFFM were responsible for reviewing the manuscript. MFFM was responsible for statistical analysis. All authors have read and agreed to the published version of the manuscript.

Research paper thumbnail of Indeterminate form of Chagas disease: historical, conceptual, clinical, and prognostic aspects

Revista da Sociedade Brasileira de Medicina Tropical, 2021

Research paper thumbnail of Benznidazole decreases the risk of chronic Chagas disease progression and cardiovascular events: A long-term follow up study

Research paper thumbnail of Fibrose Cardíaca e Mudanças Evolutivas na Função Ventricular Esquerda em Pacientes com Cardiopatia Chagásica Crônica

Arquivos Brasileiros de Cardiologia, 2021

Research paper thumbnail of Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort

Tropical Medicine and Infectious Disease, 2020

Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to ... more Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to develop the cardiac form. However, the actual rate of progression to the cardiac form is still unknown. Methods: In total, 550 patients with the indeterminate CD form were followed by means of annual electrocardiogram at our outpatient clinic. The studied endpoint was progression to cardiac form defined by the appearance of electrocardiographic changes typical of CD. The progression rate was calculated as the cumulative progression rate and the incidence progression rate per 100 patient years. Results: Thirty-seven patients progressed to the CD cardiac form within a mean of 73 ± 48 months of follow-up, which resulted in a 6.9% cumulative progression rate and incidence rate of 1.48 cases/100 patient years. Patients who progressed were older (mean age 47.8 ± 12.2 years), had a higher prevalence of associated heart diseases (p < 0.0001), positive xenodiagnosis (p = 0.007), and were born ...

Research paper thumbnail of Case Report: Malignant Ventricular Arrhythmias Mimicking Acute Coronary Syndrome in Chagas Disease

The American Journal of Tropical Medicine and Hygiene, 2020

Research paper thumbnail of A protocol update for the Selenium Treatment and Chagasic Cardiomyopathy (STCC) trial

Trials, Jan 19, 2018

Several studies evaluating clinical forms of chronic Chagas disease show that about one-third of ... more Several studies evaluating clinical forms of chronic Chagas disease show that about one-third of patients present cardiac involvement. Heart failure, sudden death and cardioembolic stroke are the main mechanisms of death in Chagas heart disease. The impact of specific etiologic treatment on the prognosis of patients with chronic Chagas heart disease is very limited regardless of the presence or absence of heart failure. Patients with symptomatic Chagas heart disease present serum selenium (Se) levels lower than patients without Chagas heart disease. Moreover, Se supplementation in animal models showed promising results. The aim of this trial is to estimate the effect of Se treatment on prevention of heart disease progression in patients with Chagas cardiomyopathy. However, we had to introduce some protocol modifications in order to keep trial feasibility, as follows: the primary outcome was restricted to left ventricular ejection fraction as a continuous variable, excluding disease ...

Research paper thumbnail of Myocardial Edema without Fibrosis by Magnetic Resonance T2 Mapping in Acute Chagas' Myocarditis

Arquivos Brasileiros de Cardiologia, 2017

Research paper thumbnail of Progressive Chagas' cardiomyopathy is associated with low selenium levels

The American Journal of Tropical Medicine and Hygiene, 2002

Selenium (Se) deficiency is linked with some cardiomyopathies. Its status was determined in 170 p... more Selenium (Se) deficiency is linked with some cardiomyopathies. Its status was determined in 170 patients with chronic Chagas' disease from 2 Brazilian regions (Rio de Janeiro and Belo Horizonte), clinically stratified into groups as follows: indeterminate or asymptomatic (IND); cardiac asymptomatic (CARDa); cardiac symptomatic with moderate to severe heart dysfunction (CARDb); and healthy adults (HA), used for comparison. In most HA, Se levels were normal, excluding an overall Se deficiency. Se was significantly lower in CARDb than in HA, IND, or CARDa patients. This was not associated with a concomitant decrease in activity of glutathione peroxidase. Thyrotropin was normal, excluding iodine deficiency. Se correlated positive and significantly with ventricular ejection fraction (assessed via echocardiography). Asymptomatic children with acute Chagas' disease had normal Se as well as 5 noninfectious cases of cardiomyopathy. Low Se was found in 6 of 10 chagasic patients with digestive megasyndromes. Thus, the decrease in Se in chagasic patients seems to be a biological marker for Trypanosoma cruzi infection and related to the progression of pathology.

Research paper thumbnail of Evolution of anti-Trypanosoma cruzi antibody production in patients with chronic Chagas disease: Correlation between antibody titers and development of cardiac disease severity

PLoS neglected tropical diseases, 2017

Chagas disease is one of the most important endemic infections in Latin America affecting around ... more Chagas disease is one of the most important endemic infections in Latin America affecting around 6-7 million people. About 30-50% of patients develop the cardiac form of the disease, which can lead to severe cardiac dysfunction and death. In this scenario, the identification of immunological markers of disease progression would be a valuable tool for early treatment and reduction of death rates. In this observational study, the production of anti-Trypanosoma cruzi antibodies through a retrospective longitudinal follow-up in chronic Chagas disease patients´ cohort and its correlation with disease progression and heart commitment was evaluated. Strong inverse correlation (ρ = -0.6375, p = 0.0005) between anti-T. cruzi IgG1 titers and left ventricular ejection fraction (LVEF) in chronic Chagas cardiomyopathy (CCC) patients were observed after disease progression. Elevated levels of anti-T. cruzi IgG3 titers were detected in all T. cruzi-infected patients, indicating a lack of correlati...

Research paper thumbnail of Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

Revista da Sociedade Brasileira de Medicina Tropical, 2016

Introduction: With the globalization of Chagas disease, unexperienced health care providers may h... more Introduction: With the globalization of Chagas disease, unexperienced health care providers may have difficulties in identifying which patients should be examined for this condition. This study aimed to develop and validate a diagnostic clinical prediction model for chronic Chagas disease. Methods: This diagnostic cohort study included consecutive volunteers suspected to have chronic Chagas disease. The clinical information was blindly compared to serological tests results, and a logistic regression model was fit and validated. Results: The development cohort included 602 patients, and the validation cohort included 138 patients. The Chagas disease prevalence was 19.9%. Sex, age, referral from blood bank, history of living in a rural area, recognizing the kissing bug, systemic hypertension, number of siblings with Chagas disease, number of relatives with a history of stroke, ECG with low voltage, anterosuperior divisional block, pathologic Q wave, right bundle branch block, and any kind of extrasystole were included in the final model. Calibration and discrimination in the development and validation cohorts (ROC AUC 0.904 and 0.912, respectively) were good. Sensitivity and specificity analyses showed that specificity reaches at least 95% above the predicted 43% risk, while sensitivity is at least 95% below the predicted 7% risk. Net benefit decision curves favor the model across all thresholds. Conclusions: A nomogram and an online calculator (available at http://shiny.ipec.fiocruz.br:3838/ pedrobrasil/chronic_chagas_disease_prediction/) were developed to aid in individual risk estimation.

Research paper thumbnail of Cardiopatia chagásica crônica no Rio Negro, Estado do Amazonas. Relato de três novos casos autóctones, comprovados por exames sorológicos, clínicos, radiográficos do tórax, eletro e ecocardiográficos

Revista da Sociedade Brasileira de Medicina Tropical, 2006

São relatados três novos casos de miocardiopatia chagásica crônica em pacientes autóctones do Rio... more São relatados três novos casos de miocardiopatia chagásica crônica em pacientes autóctones do Rio Negro, Estado do Amazonas, confirmados por sorologia (imunofluorescência, ELISA e Western-blot para infecção pelo Trypanosoma cruzi) e por exames clínicos, radiográficos, eletro e ecocardiográficos. Os pacientes nasceram e sempre viveram na região do Rio Negro, tendo sido picados numerosas vezes por triatomíneos silvestres em piaçabais da área. O quadro clínico foi de insuficiência cardíaca congestiva e distúrbio da condução intraventricular nos três casos (BRD com HBAE em dois casos e BRE de terceiro grau em um caso), extra-sístoles ventriculares polimórficas em dois casos e alteração primária da repolarização ventricular em um deles. A avaliação ecocardiográfica revelou importante aumento dos diâmetros cavitários do VE, com fração da ejeção < 36% e padrão segmentar de acometimento miocárdico, incluindo aneurisma apical e acinesia ínfero-posterior nos três pacientes. Estes são os pr...

Research paper thumbnail of Morbidade da doença de Chagas em pacientes autóctones da microrregião do Rio Negro, Estado do Amazonas

Revista da Sociedade Brasileira de Medicina Tropical, 2010

INTRODUÇÃO: Foi realizado um estudo soroepidemiológico e clínico em 152 indivíduos residentes no ... more INTRODUÇÃO: Foi realizado um estudo soroepidemiológico e clínico em 152 indivíduos residentes no município de Barcelos, Estado do Amazonas. Avaliou-se a soroprevalência da infecção chagásica e a morbidade da doença de Chagas. MÉTODOS: Os testes sorológicos foram a imunofluorescência indireta, ELISA convencional e recombinante e o Tesa-blot. Foram considerados soropositivos 38 pacientes, duvidosos 31 e soronegativos negativos 83. Os 38 casos soropositivos foram pareados com 38 controles soronegativos da mesma idade, sexo e submetidos à avaliação epidemiológica, clínica, eletro e ecocardiográfica, sendo que, 29 pares fizeram exame radiológico do esôfago. RESULTADOS: A soropositividade foi 19,9 vezes mais frequente nos trabalhadores do extrativismo em geral e 10,4 vezes mais frequente no extrativismo da piaçaba. Aplicou-se o teste de reconhecimento com o vetor local do gênero Rhodnius e 86,7% dos pacientes soropositivos o reconheceram, enquanto somente 34,2% dos soronegativos o fizeram...

Research paper thumbnail of Electrocardiographic Ventricular Repolarization Parameters in Chronic Chagas' Disease as Predictors of Asymptomatic Left Ventricular Systolic Dysfunction

Pacing and Clinical Electrophysiology, 2003

Electrocardiographic repolarization parameters are potential markers of arrhythmogenic risk and h... more Electrocardiographic repolarization parameters are potential markers of arrhythmogenic risk and have not been evaluated in Chagas' disease. The aim of this report was to investigate their associations with LV systolic function assessed by two‐dimensional echocardiography. In a cross‐sectional study involving 738 adult outpatients in the chronic phase of Chagas' disease, maximal QTc and T wave peak‐to‐end (TpTe) intervals, and QT, QTapex (QTa), JT and TpTe interval dispersions, and variation coefficients were measured and calculated from 12‐lead standard ECGs. Clinical, radiological, ECG, and echocardiographic data were recorded. In bivariate statistical analysis, all repolarization parameters were significantly increased in patients with moderate or severe LV systolic dysfunction, and these patients showed more clinical, radiologic, and ECG abnormalities. Receiver operating characteristic curve analysis demonstrated that isolatedly QTd had the best predictive performance for...

Research paper thumbnail of Implication of Transforming Growth Factor–β1 in Chagas Disease Myocardiopathy

The Journal of Infectious Diseases, 2002

Research paper thumbnail of Biodistribution of bone marrow mononuclear cells in chronic chagasic cardiomyopathy after intracoronary injection

International Journal of Cardiology, 2011

BackgroundAnimal and human clinical studies have indicated that bone marrow (BM) mononuclear cell... more BackgroundAnimal and human clinical studies have indicated that bone marrow (BM) mononuclear cell (MNC) therapy for Chagasic Cardiomyopathy (ChC) is feasible, safe and potentially efficacious. Nevertheless, little is known about the retention of these cells after intracoronary (IC) infusion.

Research paper thumbnail of Dealing with initial inconclusive serological results for chronic Chagas disease in clinical practice

European Journal of Clinical Microbiology & Infectious Diseases, 2011