Microvascular Endothelial Function in a Cohort of Patients With the Cardiac Form of Chronic Chagas Disease.

Study Overview
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Brief Summary
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The present study aims to evaluate the microvascular endothelial function of a single centre cohort of patients with the cardiac form of Chagas disease, and to search for associations with clinical and laboratory variables.

Detailed Description
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Chagas disease is an endemic anthropozoonosis in South America, caused by the protozoaTrypamosoma cruzi. Between 15 and 17 million people are estimated to be infected by the parasite in South America. During the chronic phase, 30 to 40% of patients develop the cardiac or intestinal forms of the disease. The myocardial involvement is divided in two subtypes, according to the presence or absence of systolic ventricular dysfunction. The first type is characterized by heart failure symptoms. The second is acknowledged by the development of various degrees of atrioventricular blockade and by tachyarrhythmias. Microcirculation function is recognized as a fundamental aspect in the pathophysiology of cardiovascular diseases. The identification of endothelial dysfunction by techniques that assess the microvasculature is considered as both a progression and prognostic marker in various conditions, including hypertension, coronary heart disease, and heart failure. The effects of T. cruzi infection in vascular function were evaluated in previous studies, performed in animals with acute infection. Previous studies in humans observed medium size vessels (brachial artery), in small groups of patients, most without cardiac dysfunction. There are no studies evaluating the microcirculation of patients with the cardiac form of Chagas disease.

Official Title
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Microvascular Endothelial Function in a Cohort of Patients With the Cardiac Form of Chronic Chagas Disease.

Conditions
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Chagas Cardiomyopathy

Intervention / Treatment
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* Diagnostic Test: skin laser speckle contrast imaging and video-capillaroscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients presenting with Chagas cardiomyopathy Exclusion Criteria: diabetes
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients presenting with Chagas cardiomyopathy<br>Evaluation of systemic microvascular reactivity using laser speckle contrast imaging Evaluation of skin capillary density using video-capillaroscopy | Diagnostic Test: skin laser speckle contrast imaging and video-capillaroscopy<br>* Evaluation of endothelial-dependent microvascular reactivity and capillary recruitment<br>|
| control group<br>Evaluation of systemic microvascular reactivity using laser speckle contrast imaging Evaluation of skin capillary density using video-capillaroscopy | Diagnostic Test: skin laser speckle contrast imaging and video-capillaroscopy<br>* Evaluation of endothelial-dependent microvascular reactivity and capillary recruitment<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Endothelium-dependent skin microvascular function | systemic microvascular vasodilation induced by endothelium-dependent agents | 2 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Endothelium-dependent skin capillary density | capillary opening induced by post-occlusive reactive hyperemia | 1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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endothelial function, microvascular, laser speckle contrast imaging, capillaroscopy, skin