Avaliação do sistema nervoso autonômico de pacientes com a forma aguda da Doença de Chagas pré e pós tratamento com benzonidazol

Abstract

Chagas disease (CD) is a neglected disease endemic in Latin America, which has as etiologic agent the protozoan Trypanosoma cruzi. It affects about 10 million people worldwide. The development of disease occurs in acute and chronic stages. The acute phase is characterized by intense inflammatory period due to rapid proliferation of the parasite. One of the pathophysiological characteristics of Chagas disease is the presence of dysautonomia, however in patients with acute phase there are no studies The aim of this study was to evaluate the autonomic nervous system heart of Chagas patients in acute form. We assessed thirty individuals divided into two groups: control group 15 healthy subjects and chagasic group (CaG) consisted of 15 patients diagnosed with acute Chagas disease. All groups were matched with each other, according to gender and age. electrocardiogram examinations were performed, and echocardiogram to assess autonomic nervous system (ANS) was evaluated heart rate variability (HRV) with 24-hour Holter and a pulse frequency counter POLLAR® the mark for assessment of short periods. There was no difference between groups with respect to age, weight, height, body mass index (BMI), systolic blood pressure (SBP) or diastolic blood pressure (DBP) and heart rate (HR). The electrocardiogram test (ECG) found 12 (73%) patients with normal ECG and 3 (27%) with minimal changes. In Holter 24 hours, both the overall assessment of parameters of SNA (SDNN and SDANN) as the evaluation parameters of the parasympathetic activity (rMSSD and pNN50) showed significant differences (p <0.05) between CaG groups and comparison group and between pre and post treatment CaG group. In the evaluation of HRV in short periods, the rates of assessment of parasympathetic activity, such as rMSSD, pNN50 and high-frequency component in absolute values were lower in CaG group in pre-treatment phase in the post-treatment phase. Therefore, we believe that the changes in SNA found in our study underlie our hypothesis that HRV changes manifestations occur already in the acute phase of DC and show improvement after treatment.