Cardiac Alterations in Human African Trypanosomiasis (T.b. gambiense) with Respect to the Disease Stage and Antiparasitic Treatment

被引：28

作者：

Blum, Johannes A. ^{[1
]}

Schmid, Caecilia ^{[1
]}

Burri, Christian ^{[1
]}

Hatz, Christoph ^{[1
]}

Olson, Carol ^{[3
]}

Fungula, Blaise ^{[7
]}

Kazumba, Leon ^{[5
]}

Mangoni, Patrick ^{[7
]}

Mbo, Florent ^{[8
]}

Deo, Kambau ^{[6
]}

Mpanya, Alain ^{[9
]}

Dala, Amadeo ^{[4
]}

Franco, Jose R. ^{[10
]}

Pohlig, Gabriele ^{[1
]}

Zellweger, Michael J. ^{[2
]}

机构：

[1] Swiss Trop Inst, CH-4002 Basel, Switzerland

[2] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland

[3] Immtech Pharmaceut Inc, Vernon Hills, IL USA

[4] Inst Combate Controlo Tripanossomiases, Luanda, Angola

[5] Ctr Neuro Psycho Pathol, Kinshasa, DEM REP CONGO

[6] Hop Evangel Kikongo, Kikongo, DEM REP CONGO

[7] Hop Evangel Vanga, Vanga, DEM REP CONGO

[8] Hop Gen Reference Bandundu, Bandundu, DEM REP CONGO

[9] CDTC Maluku, Maluku, DEM REP CONGO

[10] Malteser Hosp, Malteser Int, Yei, Sudan

来源：

PLOS NEGLECTED TROPICAL DISEASES | 2009年 / 3卷 / 02期

关键词：

SLEEPING SICKNESS; BRUCEI-GAMBIENSE; MELARSOPROL; HEART; MICE;

D O I：

10.1371/journal.pntd.0000383

中图分类号：

R51 [传染病];

学科分类号：

100201 [内科学];

摘要：

Background: In Human African Trypanosomiasis, neurological symptoms dominate and cardiac involvement has been suggested. Because of increasing resistance to the available drugs for HAT, new compounds are desperately needed. Evaluation of cardiotoxicity is one parameter of drug safety, but without knowledge of the baseline heart involvement in HAT, cardiologic findings and drug-induced alterations will be difficult to interpret. The aims of the study were to assess the frequency and characteristics of electrocardiographic findings in the first stage of HAT, to compare these findings to those of second stage patients and healthy controls and to assess any potential effects of different therapeutic antiparasitic compounds with respect to ECG changes after treatment. Methods: Four hundred and six patients with first stage HAT were recruited in the Democratic Republic of Congo, Angola and Sudan between 2002 and 2007 in a series of clinical trials comparing the efficacy and safety of the experimental treatment DB289 to the standard first stage treatment, pentamidine. These ECGs were compared to the ECGs of healthy volunteers (n = 61) and to those of second stage HAT patients (n = 56). Results: In first and second stage HAT, a prolonged QTc interval, repolarization changes and low voltage were significantly more frequent than in healthy controls. Treatment in first stage was associated with repolarization changes in both the DB289 and the pentamidine group to a similar extent. The QTc interval did not change during treatment. Conclusions: Cardiac involvement in HAT, as demonstrated by ECG alterations, appears early in the evolution of the disease. The prolongation of the QTC interval comprises a risk of fatal arrhythmias if new drugs with an additional potential of QTC prolongation will be used. During treatment ECG abnormalities such as repolarization changes consistent with perimyocarditis occur frequently and appear to be associated with the disease stage, but not with a specific drug.

引用

页数：7

共 32 条

[1]

HUMAN AFRICAN TRYPANOSOMIASIS (TB GAMBIENSE) - A STUDY OF 16 FATAL CASES OF SLEEPING SICKNESS WITH SOME OBSERVATIONS ON ACUTE REACTIVE ARSENICAL ENCEPHALOPATHY [J].