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Baron MA, Ferreira LRP, Teixeira PC, Moretti AIS, Santos RHB, Frade AF, Kuramoto A, Debbas V, Benvenuti LA, Gaiotto FA, Bacal F, Pomerantzeff P, Chevillard C, Kalil J, Cunha-Neto E. Matrix Metalloproteinase 2 and 9 Enzymatic Activities are Selectively Increased in the Myocardium of Chronic Chagas Disease Cardiomyopathy Patients: Role of TIMPs. Front Cell Infect Microbiol 2022; 12:836242. [PMID: 35372112 PMCID: PMC8968914 DOI: 10.3389/fcimb.2022.836242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/17/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic Chagas disease (CCC) is an inflammatory dilated cardiomyopathy with a worse prognosis compared to other cardiomyopathies. We show the expression and activity of Matrix Metalloproteinases (MMP) and of their inhibitors TIMP (tissue inhibitor of metalloproteinases) in myocardial samples of end stage CCC, idiopathic dilated cardiomyopathy (DCM) patients, and from organ donors. Our results showed significantly increased mRNA expression of several MMPs, several TIMPs and EMMPRIN in CCC and DCM samples. MMP-2 and TIMP-2 protein levels were significantly elevated in both sample groups, while MMP-9 protein level was exclusively increased in CCC. MMPs 2 and 9 activities were also exclusively increased in CCC. Results suggest that the balance between proteins that inhibit the MMP-2 and 9 is shifted toward their activation. Inflammation-induced increases in MMP-2 and 9 activity and expression associated with imbalanced TIMP regulation could be related to a more extensive heart remodeling and poorer prognosis in CCC patients.
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Affiliation(s)
- Monique Andrade Baron
- Laboratory of Immunology, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo, School of Medicine, São Paulo, Brazil
- Institute for Investigation in Immunology, Institutos Nacionais de Ciência e Tecnologia (INCT), São Paulo, Brazil
| | - Ludmila Rodrigues Pinto Ferreira
- Laboratory of Immunology, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo, School of Medicine, São Paulo, Brazil
- Institute for Investigation in Immunology, Institutos Nacionais de Ciência e Tecnologia (INCT), São Paulo, Brazil
- Department of Bioengineering, Universidade Santo Amaro, São Paulo, Brazil
| | - Priscila Camillo Teixeira
- Laboratory of Immunology, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo, School of Medicine, São Paulo, Brazil
- Institute for Investigation in Immunology, Institutos Nacionais de Ciência e Tecnologia (INCT), São Paulo, Brazil
| | - Ana Iochabel Soares Moretti
- Vascular Biology Laboratory, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
| | | | - Amanda Farage Frade
- Laboratory of Immunology, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo, School of Medicine, São Paulo, Brazil
- Institute for Investigation in Immunology, Institutos Nacionais de Ciência e Tecnologia (INCT), São Paulo, Brazil
| | - Andréia Kuramoto
- Laboratory of Immunology, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
- Institute for Investigation in Immunology, Institutos Nacionais de Ciência e Tecnologia (INCT), São Paulo, Brazil
| | - Victor Debbas
- Department of Bioengineering, Universidade Santo Amaro, São Paulo, Brazil
| | - Luiz Alberto Benvenuti
- Division of Transplantation, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Fabio Antônio Gaiotto
- Vascular Biology Laboratory, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Fernando Bacal
- Vascular Biology Laboratory, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Pablo Pomerantzeff
- Vascular Biology Laboratory, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Christophe Chevillard
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMR_1090, Aix Marseille Université, TAGC Theories and Approaches of Genomic Complexity, Institut MarMaRa, Marseille, France
- *Correspondence: Edecio Cunha-Neto, ; Christophe Chevillard,
| | - Jorge Kalil
- Division of Clinical Immunology and Allergy, University of São Paulo, School of Medicine, São Paulo, Brazil
- Institute for Investigation in Immunology, Institutos Nacionais de Ciência e Tecnologia (INCT), São Paulo, Brazil
| | - Edecio Cunha-Neto
- Laboratory of Immunology, Heart Institute (InCor), University of São Paulo, School of Medicine, São Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo, School of Medicine, São Paulo, Brazil
- Institute for Investigation in Immunology, Institutos Nacionais de Ciência e Tecnologia (INCT), São Paulo, Brazil
- *Correspondence: Edecio Cunha-Neto, ; Christophe Chevillard,
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Rodríguez-Angulo HO, Colombet-Naranjo D, Maza MC, Poveda C, Herreros-Cabello A, Mendoza I, Perera JC, Goyo JD, Gironès N, Fresno M. Molecular Remodeling of Cardiac Sinus Node Associated with Acute Chagas Disease Myocarditis. Microorganisms 2021; 9:microorganisms9112208. [PMID: 34835334 PMCID: PMC8620628 DOI: 10.3390/microorganisms9112208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 01/04/2023] Open
Abstract
Chagas disease principally affects Latin-American people, but it currently has worldwide distribution due to migration. Death among those with Chagas disease can occur suddenly and without warning, even in those who may not have evidence of clinical or structural cardiac disease and who are younger than 60 years old. HCN4 channels, one of the principal elements responsible for pacemaker currents, are associated with cardiac fetal reprogramming and supraventricular and ventricular arrhythmias, but their role in chagasic arrhythmias is not clear. We found that a single-dose administration of ivabradine, which blocks HCN4, caused QTc and QRS enlargement and an increase in P-wave amplitude and was associated with ventricular and supraventricular arrhythmias in mice challenged with isoproterenol, a chronotropic/ionotropic positive agent. Continuous treatment with ivabradine did not alter the QTc interval, but P-wave morphology was deeply modified, generating supraventricular arrhythmias. In addition, we found that repolarization parameters improved with ivabradine treatment. These effects could have been caused by the high HCN4 expression observed in auricular and ventricular tissue in infected mice. Thus, we suggest, for the first time, that molecular remodeling by overexpression of HCN4 channels may be related to supraventricular arrhythmias in acute Chagas disease, causing ivabradine over-response. Thus, ivabradine treatment should be administered with caution, while HCN4 overexpression may be an indicator of heart failure and/or sudden death risk.
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Affiliation(s)
- Héctor O. Rodríguez-Angulo
- Instituto Venezolano de Investigaciones Científicas, Caracas 1020A, Venezuela; (H.O.R.A.); (D.C.-N.)
- Unidad de Biología Celular, Departamento de Ciencias Morfológicas, Programa de Medicina, Facultad de Ciencias de la vida, Universidad Centroccidental Lisandro Alvarado, Barquisimeto 3001, Venezuela; (J.C.P.); (J.D.G.)
| | - Diana Colombet-Naranjo
- Instituto Venezolano de Investigaciones Científicas, Caracas 1020A, Venezuela; (H.O.R.A.); (D.C.-N.)
| | - María C. Maza
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.C.M.); (C.P.); (A.-H.C.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, 28049 Madrid, Spain
| | - Cristina Poveda
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.C.M.); (C.P.); (A.-H.C.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, 28049 Madrid, Spain
| | - Alfonso Herreros-Cabello
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.C.M.); (C.P.); (A.-H.C.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, 28049 Madrid, Spain
| | - Iván Mendoza
- Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas 1060, Venezuela;
| | - Juan C. Perera
- Unidad de Biología Celular, Departamento de Ciencias Morfológicas, Programa de Medicina, Facultad de Ciencias de la vida, Universidad Centroccidental Lisandro Alvarado, Barquisimeto 3001, Venezuela; (J.C.P.); (J.D.G.)
| | - Juan D. Goyo
- Unidad de Biología Celular, Departamento de Ciencias Morfológicas, Programa de Medicina, Facultad de Ciencias de la vida, Universidad Centroccidental Lisandro Alvarado, Barquisimeto 3001, Venezuela; (J.C.P.); (J.D.G.)
| | - Núria Gironès
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.C.M.); (C.P.); (A.-H.C.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, 28049 Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Universitario de la Princesa, 28009 Madrid, Spain
- Correspondence: (N.G.); (M.F.)
| | - Manuel Fresno
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.C.M.); (C.P.); (A.-H.C.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, 28049 Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Universitario de la Princesa, 28009 Madrid, Spain
- Correspondence: (N.G.); (M.F.)
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CARDOSO RHANDERSON, GARCIA DANIEL, FERNANDES GILSON, HE LI, LICHTENBERGER PAOLA, VILES-GONZALEZ JUAN, COFFEY JAMESO, MITRANI RAULD. The Prevalence of Atrial Fibrillation and Conduction Abnormalities in Chagas’ Disease: A Meta-Analysis. J Cardiovasc Electrophysiol 2015; 27:161-9. [DOI: 10.1111/jce.12845] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/14/2015] [Accepted: 09/18/2015] [Indexed: 12/15/2022]
Affiliation(s)
- RHANDERSON CARDOSO
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
| | - DANIEL GARCIA
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
| | - GILSON FERNANDES
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
| | - LI HE
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
| | - PAOLA LICHTENBERGER
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
| | - JUAN VILES-GONZALEZ
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
| | - JAMES O. COFFEY
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
| | - RAUL D. MITRANI
- Division of Cardiology, Department of Internal Medicine, Jackson Memorial Hospital; University of Miami; Miami Florida USA
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Benchimol-Barbosa PR, Tura BR, Barbosa EC, Kantharia BK. Utility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study. Braz J Med Biol Res 2013; 46:974-984. [PMID: 24270912 PMCID: PMC3854332 DOI: 10.1590/1414-431x20133141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 08/06/2013] [Indexed: 11/22/2022] Open
Abstract
The SEARCH-RIO study prospectively investigated electrocardiogram (ECG)-derived variables in chronic Chagas disease (CCD) as predictors of cardiac death and new onset ventricular tachycardia (VT). Cardiac arrhythmia is a major cause of death in CCD, and electrical markers may play a significant role in risk stratification. One hundred clinically stable outpatients with CCD were enrolled in this study. They initially underwent a 12-lead resting ECG, signal-averaged ECG, and 24-h ambulatory ECG. Abnormal Q-waves, filtered QRS duration, intraventricular electrical transients (IVET), 24-h standard deviation of normal RR intervals (SDNN), and VT were assessed. Echocardiograms assessed left ventricular ejection fraction. Predictors of cardiac death and new onset VT were identified in a Cox proportional hazard model. During a mean follow-up of 95.3 months, 36 patients had adverse events: 22 new onset VT (mean±SD, 18.4±4/year) and 20 deaths (26.4±1.8/year). In multivariate analysis, only Q-wave (hazard ratio, HR=6.7; P<0.001), VT (HR=5.3; P<0.001), SDNN<100 ms (HR=4.0; P=0.006), and IVET+ (HR=3.0; P=0.04) were independent predictors of the composite endpoint of cardiac death and new onset VT. A prognostic score was developed by weighting points proportional to beta coefficients and summing-up: Q-wave=2; VT=2; SDNN<100 ms=1; IVET+ =1. Receiver operating characteristic curve analysis optimized the cutoff value at >1. In 10,000 bootstraps, the C-statistic of this novel score was non-inferior to a previously validated (Rassi) score (0.89±0.03 and 0.80±0.05, respectively; test for non-inferiority: P<0.001). In CCD, surface ECG-derived variables are predictors of cardiac death and new onset VT.
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Affiliation(s)
- P R Benchimol-Barbosa
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de JaneiroRJ, Brasil
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Benchimol-Barbosa PR. Nonlinear mathematical model for predicting long term cardiac remodeling in Chagas' heart disease: introducing the concepts of 'limiting cardiac function' and 'cardiac function deterioration period'. Int J Cardiol 2009; 145:219-221. [PMID: 19477538 DOI: 10.1016/j.ijcard.2009.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Accepted: 05/01/2009] [Indexed: 10/20/2022]
Abstract
Cardiac remodeling has been recently investigated in long term follow-up introducing a simple exponential model to describe the time course of cardiac function and dimension changes in Chagas' disease. In the present study, an improved mathematical model to equate time course and cardiac functional changes has been proposed. Present model has been derived from previously validated intuitive assumptions and tested on data set of outpatients with chronic Chagas' disease (51.3±9.4 years old), followed for up to 10 years in Rio de Janeiro, Brazil. The variables representing cardiac status at admission were plotted against respective time derivative, which appropriately fit a second order polynomial (adjusted r(2)=0.956; p<0.001), indicating that long term cardiac remodeling followed a Verhulst-Pearl (Logistic) model. The derived Logistic model provided two output constants: a time-function (2.0·10(-3)±5.4·10(-4) months(-1)·%(-1); p<0.001) and an inferior limit for left ventricular ejection fraction (19.0±0.9%; p<0.001), standing for a limit beyond life expectation is unsustainable, in Chagas' disease. Cardiac function deterioration period was promptly derived from the model, representing the period of time following indeterminate stages of the disease when cardiac function start deteriorating, and ranged from 3 to 15.8 years. An example of data of left ventricular ejection fraction of a subject followed during 10 years illustrated the model, further validating its robustness. Present data confirms that, in chronic Chagas' disease, initial insult is connected to the progression of myocardial remodeling and introduces the concepts of limiting cardiac function and cardiac deterioration period.
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Affiliation(s)
- Paulo Roberto Benchimol-Barbosa
- Department of Cardiology, Rio de Janeiro Military Fire Department Central Hospital, Rio de Janeiro, Brazil; Department of Cardiology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Gama Filho University/National Institute of Cardiology, Rio de Janeiro, Brazil.
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