Key result
High production of anti-troponin T and anti-myosin autoantibodies was associated with lower left ventricular ejection fraction in patients with chronic Chagas disease (P=0.042 and P=0.013).
Observational (n=176)
Increased production of anti-cardiac troponin T and myosin autoantibodies correlates with reduced left ventricular ejection fraction in patients with chronic Chagas disease, suggesting a role in chagasic cardiomyopathy.
Association with lower LVEF suggests possible autoimmune contribution to chagasic cardiomyopathy; hypothesis-generating and should not yet change practice.
OBJECTIVE: To evaluate the potential involvement of anti-Trypanosoma cruzi and cardiac protein antibody (IgG total and isotypes) production and their possible association with different clinical forms of human chronic Chagas disease. METHODS: IgG total and isotypes were measured by ELISA, using epimastigote and trypomastigote forms of T. cruzi as antigens and human cardiac proteins (myosin and troponin T) in sera of patients with indeterminate (IND, n = 72), cardiac (CARD, n = 47) and digestive/cardiodigestive (DIG/CARD-DIG, n = 12) clinical forms of the disease. Samples from uninfected health individuals (CONT, n = 30) and patients with ischaemic cardiomyopathy (ISCH, n = 15) were used as controls. Autoantibody levels were correlated with parameters of cardiac function obtained by electrocardiographic, radiographic and echocardiographic examinations. RESULTS: Fifty five per cent of patients were classified as IND, 35.9% as CARD and 9.1% as DIG/CARD-DIG. Greater total IgG production was observed in IND, CARD and DIG/CARD-DIG chagasic patients than in CONT and ISCH, using trypomastigote, epimastigote and cardiac antigens. Moreover, patients with CARD and DIG/CARD-DIG presented greater total IgG production (trypomastigote and epimastigote antigen) than IND, and a negative correlation was determined between total IgG and left ventricular ejection fraction (LVEF). Patients with IND and CARD presented similar higher levels of total IgG specific to troponin T and myosin than CONT and ISCH individuals. Patients with chronic Chagas disease presented a negative correlation between left ventricular ejection fraction (LVEF) and the production of anti-myosin and troponin T autoantibodies. When grouped as low and high antibody producers and compared with LVEF, we observed that high anti-troponin T (P = 0.042) and myosin (P = 0.013) producers presented lower LVEF than low producers. Moreover, there was a positive correlation (r = 0.9508, P = 0.0001) between the production of troponin T and myosin autoantibodies. CONCLUSION: These findings indicate that increased production of anti-cardiac troponin T and myosin autoantibodies probably influences the left ventricular ejection fraction and could be related to chagasic cardiomyopathy.
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Nunes et al. (2013) conducted an observational in Chronic Chagas disease (n=176). Anti-cardiac troponin T and myosin autoantibodies vs. Low antibody producers was evaluated on Left ventricular ejection fraction (LVEF) (p=0.042). High production of anti-troponin T and anti-myosin autoantibodies was associated with lower left ventricular ejection fraction in patients with chronic Chagas disease (P=0.042 and P=0.013).
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