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Association of Anti-β 1 and Anti-M2 Antibodies with Autonomic Nervous System Modulation in Patients with Chronic Chagas Cardiomyopathy
Cunha, Delma Maria; Tzirulnik, Pedro Cunha; Costa, Patricia Cristina dos Santos; Cunha, Danton Machado; Cunha, Ademir Batista da.
  • Cunha, Delma Maria; Instituto Nacional de Cardiologia. Rio de Janeiro. BR
  • Tzirulnik, Pedro Cunha; Instituto Nacional de Cardiologia. Rio de Janeiro. BR
  • Costa, Patricia Cristina dos Santos; Universidade Federal do Estado do Rio de Janeiro. Rio de Janeiro. BR
  • Cunha, Danton Machado; Instituto Nacional de Cardiologia. Rio de Janeiro. BR
  • Cunha, Ademir Batista da; Universidade Federal Fluminense. Hospital Universitário Antônio Pedro. Niterói. BR
Int. j. cardiovasc. sci. (Impr.) ; 35(3): 354-363, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1375637
ABSTRACT
Abstract

Background:

Different immune mechanisms of myocardial damage involved in the pathophysiology of Chagas disease coexist with high titers of autoantibodies induced by T. cruzi . There are few studies in the literature about the adaptive role of anti-β1 and anti-M2 antibodies in chronic Chagas cardiomyopathy (CCC).

Objectives:

To evaluate the association between anti-β1 and anti-M2 antibodies with heart rate variability (HRV) parameters on 24h Holter monitoring and the rate-pressure product (RPP) on cardiopulmonary exercise testing (CPET).

Methods:

Anti-β1 and anti-M2 antibody titers were measured by enzyme-linked immunosorbent assay (ELISA) in 64 patients affected by CCC. Analysis of HRV was performed through the time-domain indices NNs, mean NN, SDNN, SDANN, SDNN index, NNNs, RMSSD, and pNN50. Spearman's correlation coefficient was used to assess the association between antibody titers and numerical variables. The Mann-Whitney test was used for comparison between two groups. Multiple linear regression was used to identify independent variables capable of explaining anti-β1 and anti-M2 antibody titers at the 5% significance level.

Results:

On 24h Holter, during the period of greatest parasympathetic activation (200-600 a.m.), an inverse association was found between anti-β1 titers and SDNN (rs=-0.13, p =0.041, n=43), as well as a direct association between anti-M2 titers and SDANN ( r s=0.317, p =0.039, n=43). Regarding CPET variables, anti-β1 titers were directly associated with RPP (rs=0.371, p =0.005, n=56). The subgroup of patients with a normal chronotropic response showed higher anti-β1 titers than the subgroup with an impaired response (p=0.023). RPP was an independent explanatory variable for anti-β1 titers, although with a low coefficient of determination (R2=0.147).

Conclusion:

The findings of this study suggest that, in patients with CCC, anti-β1 and anti-M2 antibodies may affect HRV parameters. RPP was directly associated with higher anti-β1 titers.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Autonomic Nervous System / Chagas Cardiomyopathy / Receptors, Adrenergic, beta-1 / Receptor, Muscarinic M2 Type of study: Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Nacional de Cardiologia/BR / Universidade Federal Fluminense/BR / Universidade Federal do Estado do Rio de Janeiro/BR

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Full text: Available Index: LILACS (Americas) Main subject: Autonomic Nervous System / Chagas Cardiomyopathy / Receptors, Adrenergic, beta-1 / Receptor, Muscarinic M2 Type of study: Observational study / Prevalence study / Prognostic study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Nacional de Cardiologia/BR / Universidade Federal Fluminense/BR / Universidade Federal do Estado do Rio de Janeiro/BR