Intramyocardial adrenergic activation in chagasic cardiomyopathy and coronary artery disease.
Luciano Nastari,Felix José Alvarez Ramires,Vera Maria Cury Salemi,Barbara Maria Ianni,Fábio Fernandes,Celia Maria Cassaro Strunz,Edmundo Arteaga,Charles Mady +7 more
TL;DR: In patients with Chagas' cardiomyopathy and normal global ejection fraction there is an early cardiac denervation, when compared to coronary artery disease patients.
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Abstract: Background: Myocardial norepinephrine is altered in left ventricular impairment. In patients with Chagas’ cardiomyopathy (CC), this issue has not been addressed. Objective: To determine the level of myocardial norepinephrine in patients with CC and compare it in patients with coronary artery disease, and to relate myocardial norepinephrine to left ventricular ejection fraction (LVEF). Methods: We studied 39 patients with CC, divided into group 1: 21 individuals with normal LVEF and group 2: 18 individuals with decreased LVEF. Seventeen patients with coronary artery disease were divided into group 3: 12 individuals with normal LVEF and group 4: 5 individuals with decreased LVEF. Two-dimensional echocardiography was used to measure LVEF. Myocardial norepinephrine was determined by high-performance liquid chromatography. Results: Myocardial norepinephrine in CC with and without ventricular dysfunction was 1.3±1.3 and 6.1±4.2 pg/µg noncollagen protein, respectively (p<0.0001); in coronary artery disease with and without ventricular dysfunction, it was 3.3±3.0 and 9.8±4.2 pg/µg noncollagen protein, respectively (p<0.0001). A positive correlation was found between LVEF and myocardial norepinephrine concentration in the patients with Chagas’ cardiomyopathy (p<0.01, r = 0.57) and also in those with coronary artery disease (p<0.01, r=0.69). A significant difference was demonstrated between norepinephrine concentrations in patients with normal LVEF (groups 1 and 3; p = 0.0182), but no difference was found in patients with decreased LVEF (groups 2 and 4; p = 0.1467). Conclusion: In patients with Chagas’ cardiomyopathy and normal global ejection fraction there is an early cardiac denervation, when compared to coronary artery disease patients. (Arq Bras Cardiol. 2010; [online].ahead print, PP.0-0)
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Citations
The effect of beta-blockade on myocardial remodelling in Chagas' cardiomyopathy
Walace de Souza Pimentel,Felix José Alvarez Ramires,Barbara Maria lanni,Vera Maria Cury Salemi,Angelina M. Bilate,Edecio Cunha-Neto,Adriana Morgan Oliveira,Fábio Fernandes,Charles Mady +8 more
TL;DR: Carvedilol did not attenuate cardiac remodeling or mortality in this model of Chagas' cardiomyopathy, but the treatment did improve survival in the acute phase of the disease.
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