Document Detail

Sleeping hearts: the role of the heart in sleeping sickness (human African trypanosomiasis).
MedLine Citation:
PMID:  18076548     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To estimate the frequency and evolution of heart involvement in human African trypanosomiasis (HAT) using electrocardiogram (ECG) findings; to describe these findings and to assess the frequency and clinical relevance of symptoms and signs before and after treatment. METHODS: In a prospective cohort study ECG findings, signs and symptoms consistent with heart failure and cardiac laboratory parameters were studied at baseline, 2 days after the end of treatment and 3 months later. RESULTS: Major ECG alterations were significantly more frequent in HAT patients than in healthy controls (71%vs. 18%; P < 0.001); 31% were low voltage changes, 34% were repolarization changes. ECG signs of necrosis and conduction problems were rare. Symptoms consistent with heart failure such as exertional dyspnoea (19%vs. 1.7%; P = 0.002) or palpitations (18%vs. 5%; P = 0.28) occurred more frequently in patients than in controls. The median NT-proBNP was significantly higher in HAT patients than in controls (85.2 vs. 28 pg/ml; P < 0.001). Troponin levels were normal. At the end of treatment repolarization changes appeared or worsened in 33.4%. Such changes improved or disappeared at follow-up in 33.1% of the patients. CONCLUSIONS: Cardiac involvement documented by ECG alterations is common in HAT patients, but cardiopathy rarely causes severe congestive heart failure and subsides after treatment. ECG alterations immediately after treatment and their improvement 3 months later may be the result of a treatment-induced inflammatory reaction.
Johannes A Blum; Christian Burri; Christoph Hatz; Leon Kazumba; Patrick Mangoni; Michael J Zellweger
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Tropical medicine & international health : TM & IH     Volume:  12     ISSN:  1365-3156     ISO Abbreviation:  Trop. Med. Int. Health     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-13     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610576     Medline TA:  Trop Med Int Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  1422-32     Citation Subset:  IM    
Swiss Tropical Institute, Basel, Switzerland.
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MeSH Terms
Eflornithine / therapeutic use*
Heart Diseases / drug therapy*,  parasitology*,  physiopathology
Melarsoprol / therapeutic use*
Trypanocidal Agents / therapeutic use*
Trypanosoma brucei gambiense / pathogenicity*
Trypanosomiasis, African / physiopathology*
Reg. No./Substance:
0/Trypanocidal Agents; 494-79-1/Melarsoprol; 70052-12-9/Eflornithine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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