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Final Program


Program-At-A-Glance

Rapid Fire Session

Session: Rapid Fire Session 2: Multicenter Clinical Trials and Cardiomyopathy (Monitor 10)

Correlation between inflammatory biomarkers with myocardial injury by cardiac magnetic resonance: unlocking prognosis of acute Chagas disease.

Thursday, February 5, 2026
4:06 PM - 4:13 PM  
Location: Galapagos / Aruba / Ilhabela (2nd Lower Level)
Background: Post-inflammatory myocardial injury can be identified by cardiac magnetic resonance imaging (cMRI) which allows an important predictor of arrhythmia and sudden death in several nonischemic cardiomyopathies, including chronic chagasic cardiomyopathy. Approaching early myocardial injury during the acute phase of Chagas disease may play a potential role for prognostic and diagnostic value. Therefore, the aim of this study was to evaluate myocardial injury in patients with acute Chagas disease before and after treatment and correlate with inflammatory biomarkers.

Methods: This longitudinal study was developed at the Chagas Disease Outpatient Clinic of Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus - AM, from 2017 to 2022. Serum cytokines: IL-1α, IL-2, IL-4, IL-5, IL-6, IL-10, and IL-17α, as well as TNF-α, IFN-g and galectin-3 were analyzed.

Results: Thirty-five patients with acute CD and 14 controls were included between 2017 and 2022, with a mean age of 46.3 ± 17.8 years, mostly male 20 (57.1%), and from three oral transmission outbreaks, with 26 (74.3%) patients. cMRI was performed in 22/35 (62.9%) of the individuals in the pre-treatment group and 15/25 (60%) of the post-treatment group to detect myocardial injury by the presence of late gadolinium enhancement (LGE). LGE was found in 27.3% (n=6) and 33.3% (n=5), respectively. No signs of edema were observed. In the pre-treatment period, a predominant negative correlation was observed between the measured cytokines and the percentage of LV mass of LGE reported on cMRI. IL-1α, IL-17α and IL-4 showed a moderate (0.36 to 0.67) significant correlation with the presence of LGE. The exception was a positive correlation with IL-10, an important anti-inflammatory biomarker (ρ = 0.19, p-value: 0. 428) (Figure 1). Regarding the post-treatment period, it was possible to observe a distinct pattern in which there is a predominance of positive correlations, even if weak (IL-6, TNF-α and IL-10) (Figure 2). There was a weak negative correlation between Gal-3 levels and the percentage of LV mass affected in the pre-treatment group (Figure 3A). Conversely, a moderate positive correlation was detected in the group after standard etiological treatment for 60 days (Figure 3B).

Conclusion: IL-1α, IL-17α, and IL-4 showed a moderate (0.36 to 0.67) significant negative correlation with the presence of LGE and Gal-3 showed negative correlations with % LV mass on cMRI before treatment, suggesting a possible protective factor. After treatment, IL-10 and Gal-3 showed positive correlations with % LV mass on cMRI, revealing the importance of early detection and long-term follow-up of the cardiac impairment in these patients.

Figure 1 – Pearson correlation (ρ) between LGE (% LV mass) and serum levels of cytokines in the pre-treatment group.
Figure 2 – Pearson correlation (ρ) between LGE (% LV mass) and serum levels of cytokines in the post-treatment group.
Figure 3 – Pearson correlation (ρ) between late enhancement (% LV mass) and serum Gal-3 levels in the pre-treatment group (A) and in the post-treatment group (B).