Matheus Ribeiro Ávila, Daniel Menezes de Souza, Lucas Fróis Fernandes de Oliveira, Pedro Henrique Scheidt Figueiredo, Liliany Mara Carvalho Silva, Whesley Tanor Silva, Mauro Felippe Felix Mediano, Leonardo Augusto da Costa Teixeira, Luciano Fonseca Lemos de Oliveira, Marcus Alessandro de Alcantara, Sanny Cristina de Castro Faria, Arthur Nascimento Arrieiro, Vanessa Amaral Mendonça, Ana Cristina Rodrigues Lacerda, Henrique Silveira Costa
{"title":"可溶性TNF受体在恰加斯心肌病中的预后价值：观察性研究。","authors":"Matheus Ribeiro Ávila, Daniel Menezes de Souza, Lucas Fróis Fernandes de Oliveira, Pedro Henrique Scheidt Figueiredo, Liliany Mara Carvalho Silva, Whesley Tanor Silva, Mauro Felippe Felix Mediano, Leonardo Augusto da Costa Teixeira, Luciano Fonseca Lemos de Oliveira, Marcus Alessandro de Alcantara, Sanny Cristina de Castro Faria, Arthur Nascimento Arrieiro, Vanessa Amaral Mendonça, Ana Cristina Rodrigues Lacerda, Henrique Silveira Costa","doi":"10.1590/0074-02760240107","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>To verify the prognostic value of sTNFR1 and sTNFR2 in CCC.</p><p><strong>Methods: </strong>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.</p><p><strong>Findings: </strong>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).</p><p><strong>Main conclusions: </strong>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.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"120 ","pages":"e240107"},"PeriodicalIF":2.5000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic value of soluble TNF receptors in Chagas cardiomyopathy: observational study.\",\"authors\":\"Matheus Ribeiro Ávila, Daniel Menezes de Souza, Lucas Fróis Fernandes de Oliveira, Pedro Henrique Scheidt Figueiredo, Liliany Mara Carvalho Silva, Whesley Tanor Silva, Mauro Felippe Felix Mediano, Leonardo Augusto da Costa Teixeira, Luciano Fonseca Lemos de Oliveira, Marcus Alessandro de Alcantara, Sanny Cristina de Castro Faria, Arthur Nascimento Arrieiro, Vanessa Amaral Mendonça, Ana Cristina Rodrigues Lacerda, Henrique Silveira Costa\",\"doi\":\"10.1590/0074-02760240107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>To verify the prognostic value of sTNFR1 and sTNFR2 in CCC.</p><p><strong>Methods: </strong>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.</p><p><strong>Findings: </strong>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).</p><p><strong>Main conclusions: </strong>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.</p>\",\"PeriodicalId\":18469,\"journal\":{\"name\":\"Memorias do Instituto Oswaldo Cruz\",\"volume\":\"120 \",\"pages\":\"e240107\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-04-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Memorias do Instituto Oswaldo Cruz\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/0074-02760240107\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PARASITOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Memorias do Instituto Oswaldo Cruz","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/0074-02760240107","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PARASITOLOGY","Score":null,"Total":0}
Prognostic value of soluble TNF receptors in Chagas cardiomyopathy: observational study.
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.
期刊介绍：
Memórias do Instituto Oswaldo Cruz is a journal specialized in microbes & their vectors causing human infections. This means that we accept manuscripts covering multidisciplinary approaches and findings in the basic aspects of infectious diseases, e.g. basic in research in prokariotes, eukaryotes, and/or virus. Articles must clearly show what is the main question to be answered, the hypothesis raised, and the contribution given by the study.
Priority is given to manuscripts reporting novel mechanisms and general findings concerning the biology of human infectious prokariotes, eukariotes or virus. Papers reporting innovative methods for diagnostics or that advance the basic research with these infectious agents are also welcome.
It is important to mention what we do not publish: veterinary infectious agents research, taxonomic analysis and re-description of species, epidemiological studies or surveys or case reports and data re-analysis. Manuscripts that fall in these cases or that are considered of low priority by the journal editorial board, will be returned to the author(s) for submission to another journal.
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