β1-Selective Adrenoceptor Antagonists Increase Plasma Levels of Anti-p2β Antibodies and Decrease Cardiac Involvement in Chronic Progressive Chagas Heart Disease.

VICCO MIGUEL; PUJATO NAZARENA; BONTEMPI IVAN; RODELES LUZ; MARCIPAR IVÁN; BOTASSO OSCAR

CANADIAN JOURNAL OF CARDIOLOGY

PULSUS GROUP INC

Lugar: Ontario; Año: 2014 vol. 30 p. 332 - 337

0828-282X

Background: Studies indicate that antibodies cross-reacting with cardiac β1 adrenergic receptors are likely to play a role in the development of chronic Chagas heart disease (CCHD). In parallel, clinical trials have shown that β1 antagonist drugs exert beneficial effects in the prognosis of patients with CCHD. In a group of patients with CCHD undergoing therapy with 1blockers, we have now evaluated the levels of anti-p2β antibodies as well as the severity of CCHD. Methods: We performed a cross-sectional study in T. cruzi seropositive patients categorized according to a standard CCHD classification. All individuals were subjected to a complete clinical examination. Results: There was no association between CCHD stages, electrocardiographic conduction disturbances and echocardiogram pathological signs with the levels of autoantibodies. However, when patients were analyzed according to selective cardio β1 blockers therapy, those receiving treatment had higher levels of anti-p2β. Patients from CCHD stage III treated with combined therapy of cardio-β1 selective blockers, enalapril, and statins, presented decreased cardiac involvement and lower score of risk mortality than individuals from the same group not treated. Conclusions: Our results suggest that selective cardio β1 blockers may modify the auto-antibodies anti-p2β levels, and that combined therapy in patients with CCHD stage III might be associated with lower cardiac involvement and risk score of mortality in patients with heart failure. Longitudinal studies will help to ascertain the proper role of 1 blockers in the immunopathological processes underlying chronic Chagas disease.