[C-reactive protein and interleukin-6 serum levels increase as Chagas disease progresses towards cardiac failure]. / Las concentraciones séricas de interleucina-6 y proteína C reactiva se incrementan a medida que la enfermedad de Chagas evoluciona hacia el deterioro de la función cardíaca.

INTRODUCTION AND OBJECTIVES: Chagas disease is the most common cause of myocarditis in Latin America, including Venezuela. Some 25% of patients progress to chronic chagasic cardiomyopathy, which is characterized by heart failure and arrhythmias. The serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) have prognostic value in non-chagasic cardiopathy. The goal of this study was to investigate the relationship between the serum levels of CRP and IL-6 and the developmental stage of Chagas disease. PATIENTS AND METHOD: The study included 64 Chagas disease patients (34 female and 30 male; age 62.2 [1.7] years) and 20 healthy individuals (10 of each sex; age 50.4 [2.7] years). Clinical investigations included echocardiography and measurement of CRP and IL-6 serum levels using ELISAs. Chagas disease patients were graded according to Carrasco et al 1994 classification. Patients with ischemic cardiopathy, liver disease, autoimmune disease, a systemic inflammatory condition, immunosuppression, cancer, pericarditis, or endocarditis were excluded. RESULTS: Multiple regression analysis demonstrated an association between Chagas disease developmental stage and the serum IL-6 level. The serum CRP level increased during only the most advanced phase of the disease. In addition, a high left ventricular mass index was associated with a high IL-6 level and male sex. CONCLUSIONS: IL-6 and CRP serum levels could be of prognostic value in assessing Chagas disease progression because there are significant correlations between elevated levels and the deterioration of cardiac function.

Las concentraciones séricas de interleucina-6 y proteína C reactiva se incrementan a medida que la enfermedad de Chagas evoluciona hacia el deterioro de la función cardíaca / C-reactive protein and interleukin-6 serum levels increase as Chagas disease progresses towards cardiac failure

Introducción y objetivos. La enfermedad de Chagas (EC) es la causa de miocarditis más común en América Latina y Venezuela. El 25% de los pacientes evoluciona hacia una miocardiopatía chagásica crónica (MCC), caracterizada por insuficiencia cardíaca y arritmias. La proteína C reactiva (PCR) y la interleucina-6 (IL-6) tienen valor pronóstico en las cardiopatías no chagásicas. En este estudio se ha determinado la relación entre las concentraciones de PCR e IL-6 y la fase evolutiva de la EC. Pacientes y método. Se incluyó a 64 pacientes con EC (34 mujeres y 30 varones; edad: 62,2 ± 1,7 años) y a 20 individuos sanos (10 de cada sexo; edad: 50,4 ± 2,7 años); en todos ellos se realizaron una valoración clínica, una ecocardiografía y la determinación de las concentraciones séricas de PCR e IL-6 mediante ELISA. Los pacientes fueron clasificados según Carrasco et al (1994). Se excluyó a los pacientes con cardiopatía isquémica, hepatopatías, enfermedades autoinmunitarias, procesos inflamatorios, neoplasias, inmunodepresión, pericarditis y endocarditis. Resultados. El análisis de regresión múltiple mostró una asociación entre la fase evolutiva de la EC y las concentraciones de IL-6, mientras que los valores elevados de PCR sólo estuvieron asociados con la fase más avanzada de la EC. Adicionalmente, se observó un mayor índice de masa del ventrículo izquierdo asociado con valores elevados de IL-6 y el sexo masculino. Conclusiones. Los valores de IL-6 están correlacionadas con la fase evolutiva y los de PCR con las formas más graves de la EC; ambos podrían ser considerados marcadores pronósticos de la MCC

Introduction and objectives. Chagas disease is the most common cause of myocarditis in Latin America, including Venezuela. Some 25% of patients progress to chronic chagasic cardiomyopathy, which is characterized by heart failure and arrhythmias. The serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) have prognostic value in non-chagasic cardiopathy. The goal of this study was to investigate the relationship between the serum levels of CRP and IL-6 and the developmental stage of Chagas disease. Patients and method. The study included 64 Chagas disease patients (34 female and 30 male; age 62.2 [1.7] years) and 20 healthy individuals (10 of each sex; age 50.4 [2.7] years). Clinical investigations included echocardiography and measurement of CRP and IL-6 serum levels using ELISAs. Chagas disease patients were graded according to Carrasco et al 1994 classification. Patients with ischemic cardiopathy, liver disease, autoimmune disease, a systemic inflammatory condition, immunosuppression, cancer, pericarditis, or endocarditis were excluded. Results. Multiple regression analysis demonstrated an association between Chagas disease developmental stage and the serum IL-6 level. The serum CRP level increased during only the most advanced phase of the disease. In addition, a high left ventricular mass index was associated with a high IL-6 level and male sex. Conclusions. IL-6 and CRP serum levels could be of prognostic value in assessing Chagas disease progression because there are significant correlations between elevated levels and the deterioration of cardiac function