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Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy.
- Source :
-
Memorias do Instituto Oswaldo Cruz [Mem Inst Oswaldo Cruz] 2018 Aug 20; Vol. 113 (10), pp. e180224. Date of Electronic Publication: 2018 Aug 20. - Publication Year :
- 2018
-
Abstract
- Background: Serum brain-derived neurotrophic factor (BDNF) levels have been shown to be lower in patients with Chagas cardiomyopathy (ChC) than in patients with non-dilated chagasic cardiomyopathy. However, its prognostic value was not established in patients with ChC.<br />Methods: Forty-nine patients with ChC (50 ± 7 years, New York Heart Association "NYHA" I-III); were evaluated by echocardiography, exercise testing, and blood analysis. Serum BDNF levels were determined using enzyme-linked immunosorbent assay sandwich. Patients were followed-up, and cardiac death was considered the end-point. The survival analyses were performed using Kaplan-Meier and Cox regression.<br />Results: After 39 ± 14 months of follow-up, 12 patients (25%) died. The concentration of 2.5 ng/mL was the optimal cut-off value to predict survival with significant difference between the groups with low (≤ 2.5 ng/mL) and high (> 2.5 ng/mL) BDNF levels (p = 0.006). Lower serum BDNF levels (hazards ratio (HR) 1.1, 95% confidence interval (CI) 1.1-1.4; p = 0.001), peak oxygen uptake (HR 1.2, 95% CI 1.0-1.3; p = 0.009), and left ventricular ejection fraction (HR 0.8, 95% CI 0.7-0.9; p = 0.001) were the independent predictors of survival. The combination of low serum BDNF levels and reduced left ventricular ejection fraction were highly predictive of death (HR 5.6, 95% CI: 1.2-9.7; p = 0.026).<br />Conclusion: In patients with ChC, reduced serum BDNF levels, especially if associated with systolic function, may provide useful prognostic information.
- Subjects :
- Adult
Chagas Cardiomyopathy physiopathology
Echocardiography
Enzyme-Linked Immunosorbent Assay
Exercise Test
Female
Follow-Up Studies
Heart Failure blood
Heart Failure physiopathology
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Oxygen Consumption physiology
Prognosis
Prospective Studies
Reference Standards
Risk Assessment methods
Risk Factors
Sensitivity and Specificity
Statistics, Nonparametric
Stroke Volume physiology
Time Factors
Brain-Derived Neurotrophic Factor blood
Chagas Cardiomyopathy blood
Subjects
Details
- Language :
- English
- ISSN :
- 1678-8060
- Volume :
- 113
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Memorias do Instituto Oswaldo Cruz
- Publication Type :
- Academic Journal
- Accession number :
- 30133549
- Full Text :
- https://doi.org/10.1590/0074-02760180224