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Mem Inst Oswaldo Cruz, Rio de Janeiro, VOLUME 119 | 2024

Research Articles

Sublingual microcirculatory alterations in Chagas disease: an observational study in an endemic rural population

Jorge Emilio De All^1,2, Juan Francisco Caminos Eguillor³, Simón Marcelo Cohen¹, Héctor Freilij⁴, Arnaldo Dubin^2,3,+

¹Asociación Cuerpo & Alma, Ciudad Autónoma de Buenos Aires, Argentina
²Sanatorio Otamendi, Ciudad Autónoma de Buenos Aires, Argentina
³Universidad Nacional de La Plata, Facultad de Ciencias Médicas, Cátedras de Farmacología Aplicada y Terapia Intensiva, Provincia de Buenos Aires, Argentina
⁴Hospital de Niños Ricardo Gutiérrez, Servicio de Parasitología y Enfermedad de Chagas, Ciudad Autónoma de Buenos Aires, Argentina

DOI: 10.1590/0074-02760240018

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ABSTRACT

BACKGROUND Chagas disease is a systemic illness with widespread microvascular involvement. Experimental and clinical studies suggest that functional and structural microcirculatory abnormalities might be relevant to the disease progression.
OBJECTIVES To show the presence of sublingual microcirculatory alterations in patients with chronic Chagas disease.
METHODS This was a cross-sectional study including adult patients with serologic diagnosis of Chagas disease (n = 41) and control volunteers with negative serology (n = 38), from an endemic rural population. Study participants underwent clinical, electrocardiographic, echocardiographic, and sublingual videomicroscopic assessment. Videos were acquired by a sidestream-dark-field (SDF) imaging device and evaluated by a software-assisted analysis (AVA 3.2 software).
FINDINGS Most of Chagas disease patients were in the indeterminate phase (n = 34) and had lower heart rate and more echocardiographic abnormalities than control group (50 vs. 26%, p = 0.03). They also exhibited higher small microvessels total and perfused vascular density (20.12 ± 2.33 vs. 19.05 ± 2.25 and 20.03 ± 2.28 vs. 19.01 ± 2.25 mm/mm², p < 0.05 for both). Other microvascular variables did not differ between groups.
MAIN CONCLUSIONS Patients with chronic Chagas disease exhibited increases in sublingual total and perfused microvascular density. Angiogenesis might be the underlying mechanism. The videomicroscopic assessment of mucosal sublingual microcirculation might be an additional tool in the monitoring of Chagas disease.

key words: Chagas disease microcirculation angiogenesis microvascular density

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