Prognostic value of serum brain-derived neurotrophic factor levels in patients with Chagas cardiomyopathy

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 113; no. 10; p. e180224
• Main Authors: Costa, Henrique S, Lima, Marcia Maria O, Figueiredo, Pedro Henrique S, Martinelli, Patrícia M, Camargos, Elizabeth Rs, Chaves, Ana Thereza, Nunes, Maria Carmo Pereira, Rocha, Manoel Otavio C
• Format: Journal Article
• Language: English
• Published: Brazil Instituto Oswaldo Cruz, Ministério da Saúde 20.08.2018; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: brain-derived neurotrophic factor; Chagas cardiomyopathy; echocardiogram; exercise testing; Original; PARASITOLOGY; prognosis; TROPICAL MEDICINE; exercise testing; brain-derived neurotrophic factor; prognosis; echocardiogram; Chagas cardiomyopathy
• ISSN: 0074-0276; 1678-8060; 1678-8060
• DOI: 10.1590/0074-02760180224

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. 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. 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). In patients with ChC, reduced serum BDNF levels, especially if associated with systolic function, may provide useful prognostic information.