Memorias do Instituto Oswaldo Cruz · 2025
Prognostic value of soluble TNF receptors in Chagas cardiomyopathy: observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ávila Matheus Ribeiro, de Souza Daniel Menezes, de Oliveira Lucas Fróis Fernandes, Figueiredo Pedro Henrique Scheidt, Silva Liliany Mara Carvalho, Silva Whesley Tanor, Mediano Mauro Felippe Felix, Teixeira Leonardo Augusto da Costa, de Oliveira Luciano Fonseca Lemos, de Alcantara Marcus Alessandro, Faria Sanny Cristina de Castro, Arrieiro Arthur Nascimento, Mendonça Vanessa Amaral, Lacerda Ana Cristina Rodrigues, Costa Henrique Silveira
Аннотация
BACKGROUND: Chronic Chagas cardiomyopathy (CCC) is the most severe clinical form of the Chagas disease. There is a strong correlation between soluble tumor necrosis factor receptors (sTNFR1 and sTNFR2) and cardiac and functional parameters in CCC, but their prognostic value remains unknown.
OBJECTIVE: To verify the prognostic value of sTNFR1 and sTNFR2 in CCC.
METHODS: A longitudinal study was conducted. Sixty-nine patients with CCC (53.70 ± 9.66 years, NYHA I-II) were submitted to blood collection and echocardiography, and followed for 43.81 ± 1.21 months. The outcome was determined by the combination of cardiac death, heart transplantation, or stroke.
FINDINGS: After the follow-up, 15 patients (22%) presented adverse cardiovascular events. Only left ventricular ejection fraction (LVEF) [heart rate at rest (HR): 0.935, 95% CI 0.878 to 0.994; p = 0.033] and sTNFR2 (HR: 1.002, 95% CI 1.001 to 1.003; p = 0.006) remained as independent predictors of adverse cardiovascular events. The optimal cutoff point to identify these patients was the value of 1784.00 pg/mL. There was a significant difference between the groups with lower and higher sTNFR2 levels (long-rank < 0.001).
MAIN CONCLUSIONS: High serum levels of sTNFR2, together with lower LVEF, are strong independent predictors of adverse cardiovascular events in CCC, making them valuable for risk stratification.
OBJECTIVE: To verify the prognostic value of sTNFR1 and sTNFR2 in CCC.
METHODS: A longitudinal study was conducted. Sixty-nine patients with CCC (53.70 ± 9.66 years, NYHA I-II) were submitted to blood collection and echocardiography, and followed for 43.81 ± 1.21 months. The outcome was determined by the combination of cardiac death, heart transplantation, or stroke.
FINDINGS: After the follow-up, 15 patients (22%) presented adverse cardiovascular events. Only left ventricular ejection fraction (LVEF) [heart rate at rest (HR): 0.935, 95% CI 0.878 to 0.994; p = 0.033] and sTNFR2 (HR: 1.002, 95% CI 1.001 to 1.003; p = 0.006) remained as independent predictors of adverse cardiovascular events. The optimal cutoff point to identify these patients was the value of 1784.00 pg/mL. There was a significant difference between the groups with lower and higher sTNFR2 levels (long-rank < 0.001).
MAIN CONCLUSIONS: High serum levels of sTNFR2, together with lower LVEF, are strong independent predictors of adverse cardiovascular events in CCC, making them valuable for risk stratification.