Electrocardiographic findings in Mexican chagasic subjects living in high and low endemic regions of Trypanosoma cruzi infection (original) (raw)
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Chronic Chagas cardiopathy in Chile. Importance of Trypanosoma cruzi burden and clinical evaluation
Acta Tropica, 2016
Currently there are no biological markers to indicate which individuals with chronic indeterminate period of Chagas disease develop heart disease and who will remain all his life in this phase. The aim of this survey was to determine if Trypanosoma cruzi burden is related to the presence of heart disease in patients with chronic Chagas disease. 200 patients who had not been treated, 100 with cardiopathy and 100 without, groups A and B respectively, were submitted to clinical study and electrocardiogram, Echo-Doppler was performed for group A in which all important known causes of cardiopathy were discarded. In both groups xenodiagnosis, conventional PCR and quantitative PCR were undertaken. The 100 cardiopaths had 133 electrocardiographic alterations most of them in grade II of the New York Heart Association classification. 98 cardiopaths were classified in grade I by Echo-Doppler and only 2 cases were in grade III due to low ejection fraction. The difference in average parasitemia in patients of group A and B was not significant and no statistically differences were observed between average parasitemia of cardiopaths grade II versus grade I of NYHA. This results allow to characterize same clinical, electrocardiographical and parasitological features in chagasic cardiopaths of Chile.
Parasitology Research, 2015
There are currently no biomarkers to assess which patients with chronic indeterminate Chagas disease will develop heart disease and which will spend their entire life in this state. We hypothetize that the parasite burden and Trypanosoma cruzi genotypes are related to the presence of heart disease in patients with Chagas disease. This study is aimed to investigate the parasite burden and T. cruzi genotypes in chagasic cardiopaths versus chagasic individuals without cardiac involvement according to the New York Heart Association. Patients with chronic Chagas disease, 50 with and 50 without cardiopathy (controls), groups A and B, respectively, were submitted to anamnesis, physical examination, and electrocardiogram. Echo-Doppler was performed for group A; all important known causes of cardiopathy were discarded. Xenodiagnosis, conventional PCR, and quantitative PCR were performed on patients of both groups. T. cruzi genotyping was done for 25 patients of group A and 20 of group B. The 50 cardiopaths had 80 electrocardiographic alterations, most of them in grade II of the New York Heart Association classification; 49 were classified in grade I by Echo-Doppler, and only one patient was in grade III. The difference in average parasitemia in patients of groups A and B was not significant. The most frequent T. cruzi DTU found was TcV. The parasite burden and genotype of the groups with and without cardiopathy were similar.Figure 2 Chronic Chagas cardiopathy microaneurism of left ventricle. Cineangiography.
PLoS Neglected Tropical Diseases, 2010
Chagas disease caused by Trypanosoma cruzi is a complex disease that is endemic and an important problem in public health in Latin America. The T. cruzi parasite is classified into six discrete taxonomic units (DTUs) based on the recently proposed nomenclature (TcI, TcII, TcIII, TcIV, TcV and TcVI). The discovery of genetic variability within TcI showed the presence of five genotypes (Ia, Ib, Ic, Id and Ie) related to the transmission cycle of Chagas disease. In Colombia, TcI is more prevalent but TcII has also been reported, as has mixed infection by both TcI and TcII in the same Chagasic patient. The objectives of this study were to determine the T. cruzi DTUs that are circulating in Colombian chronic Chagasic patients and to obtain more information about the molecular epidemiology of Chagas disease in Colombia. We also assessed the presence of electrocardiographic, radiologic and echocardiographic abnormalities with the purpose of correlating T. cruzi genetic variability and cardiac disease. Molecular characterization was performed in Colombian adult chronic Chagasic patients based on the intergenic region of the mini-exon gene, the 24Sa and 18S regions of rDNA and the variable region of satellite DNA, whereby the presence of T.cruzi I, II, III and IV was detected. In our population, mixed infections also occurred, with TcI-TcII, TcI-TcIII and TcI-TcIV, as well as the existence of the TcI genotypes showing the presence of genotypes Ia and Id. Patients infected with TcI demonstrated a higher prevalence of cardiac alterations than those infected with TcII. These results corroborate the predominance of TcI in Colombia and show the first report of TcIII and TcIV in Colombian Chagasic patients. Findings also indicate that Chagas cardiomyopathy manifestations are more correlated with TcI than with TcII in Colombia.
BMC Infectious Diseases, 2014
Background: American trypanosomiasis is a major disease and public health issue, caused by the protozoan parasite Trypanosoma cruzi. The prevalence of T. cruzi has not been fully documented, and there are few reports of this issue in Nuevo Leon. The aim of this study was to update the seroprevalence rate of T. cruzi infection, including an epidemiological analysis of the risk factors associated with this infection and an electrocardiographic (ECG) evaluation of those infected. Methods: Sera from 2,688 individuals from 10 municipalities in the state of Nuevo Leon, Mexico, were evaluated using an enzyme-linked immunosorbent assay and an indirect hemagglutination assay. An ECG case-control study was performed in subjects seropositive for T. cruzi and the results were matched by sex and age to seronegative residents of the same localities. A univariate analysis with χ 2 and Fisher's exact tests was used to determine the association between seropositivity and age (years), sex, and ECG changes. A multivariate analysis was then performed to calculate the odd ratios between T. cruzi seropositivity and the risk factors. Results: The seropositive rate was 1.93% (52/2,688). In the ECG study, 22.85% (8/35) of the infected individuals exhibited ECG abnormalities. Triatoma gerstaeckeri was the only vector reported. The main risk factors were ceiling construction material (P ≤ 0.0024), domestic animals (P ≤ 0.0001), and living in rural municipalities (P ≤ 0.0025). Conclusions: These findings demonstrate a 10-fold higher prevalence of Chagas disease than previously reported (0.2%), which implies a serious public health threat in northeastern Mexico. The epidemiological profile established in this study differs from that found in the rest of Mexico, where human populations live in close proximity to domiciliary triatomines.
Cardiac abnormalities in Trypanosoma cruzi seropositive patients in the State of Querétaro, México
2017
La enfermedad de Chagas es una patologia endemica en las Americas, donde representa un problema de salud publica. Se estima que aproximadamente 8 millones de personas estan infectadas y 20 millones viven en areas de riesgo de infectarse. En Mexico el problema esta subestimado y se carece de datos epidemiologicos por estado del pais que indiquen una prevalencia real de este padecimiento. Durante la fase cronica, el 30% de los pacientes infectados pueden desarrollar miocardiopatia chagasica (MCC), que se caracteriza por presentar diferentes alteraciones de la funcion cardiaca. Objetivo: Describir las alteraciones cardiacas en sujetos seropositivos para Trypanosoma cruzi de areas endemicas. Material y metodos: Es un estudio con diseno transversal descriptivo, con muestra no probabilistica. En nuestro proyecto, se considero una zona endemica a Trypanosoma cruzi, mediante el programa estadistico Epi Info (Stat Calc), para estimar el numero de sujetos a estudiar, obteniendose una muestra ...
Mixed infection of Trypanosoma cruzi I and II in a Colombian cardiomyopathic patient
Human pathology, 2010
The Trypanosoma cruzi taxon is composed of 2 major lineages, T cruzi I and T cruzi II. The clinical symptoms of Chagas disease are highly variable, and their geographic distribution is correlated with the distribution of the parasite lineages. In Colombia and northern South America, T cruzi I lineage is associated with chagasic cardiomyopathy. Alternatively, in the countries south cone of South America, there is a predominance of T cruzi II, which is associated with cardiomyopathy and digestive diseases. We report for the first time a mixed infection consisting of both T cruzi I and T cruzi II detected in the esophagus and in the heart, respectively, of a cardiomyopathic patient from an endemic area in Santander, Colombia. This finding has epidemiological relevance related to the association of T cruzi II with the clinical manifestations of Chagas disease and its frequency in Colombia and countries in northern South America.
2001
Trypanosoma cruzi infection in central Mexico has not been fully documented, yet some data suggest its presence. In this work, sera from 211 subjects living in the state of Morelos and at risk of T. cruzi infection due to their living in contact with the vector were analyzed for the presence of antibodies to a total antigen extract of a Mexican isolate of T. cruzi. A seropositivity of 20% was demonstrated by both an enzyme-linked immunosorbent assay and Western blotting. Furthermore, parasites were isolated from five seropositive individuals, and these were genetically characterized as T. cruzi by multilocus enzyme electrophoresis. A case-control electrocardiographic study was conducted that included the seropositive individuals and twice as many seronegative controls living in the same area. A significant correlation was found between seropositivity and electrocardiographic alterations. These findings have important implications for perception of the prevalence of Chagas' disease in Mexico. Moreover, the presence of this disease in rural communities rapidly transforming into urban ones might have important epidemiologic consequences.
Trypanosoma cruzi is classified into two major groups named T. cruzi I and T. cruzi II. In the present work we analyzed 16 stocks isolated from human cases and four isolated from triatomines from diverse geographical origins (Mexico and Guatemala). From human cases four were acute cases, six indeterminates, and six from chronic chagasic cardiophatic patients with diagnosis of dilated cardiomyopathy established based on the left-ventricular end systolic dimension and cardiothoracic ratio on chest X-radiography and impaired contracting ventricle and different degree conduction/rhythm aberrations. DNA samples were analyzed based on mini-exon (ME) polymorphism, using a pool of three oligonucleotide for the amplification of specific intergenic region of T. cruzi ME gene. All the Mexican and Guatemalan isolates regardless their host or vector origin generated a 350 bp amplification product. In conclusion T. cruzi I is dominant in Mexico and Guatemala even in acute and chronic chagasic car...
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018
Trypanosoma cruzi causes Chagas disease in the Americas. Outcome of infection ranges from lifelong asymptomatic status to severe disease. Understanding how history of T. cruzi lineage (TcI-TcVI) infection relates to clinical prognosis is challenging. We previously described peptide-based lineage-specific ELISA with Trypomastigote Small Surface Antigen (TSSA). A novel rapid diagnostic test (Chagas Sero K-SeT) incorporating a peptide corresponding to the TSSA-II/V/VI common epitope was developed, and validated by comparison with ELISA. Patients from Bolivia and Peru were then tested by Chagas Sero K-SeT, including individuals with varying cardiac pathology, and matched mothers and neonates. Chagas Sero K-SeT and ELISAs, with a Bolivian subset of cardiac patients, mothers and neonates, were in accord. In adult chronic infections (n = 121), comparison of severity class A (no evidence of Chagas cardiomyopathy) against classes B (ECG suggestive of Chagas cardiomyopathy) and C/D (moderate/...