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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Cardiac alterations in human African trypanosomiasis (T.b. gambionse) with respect to the disease stage and antiparasitic treatment
PLoS Neglected Tropical Diseases, Volume 3, No. 2, Article e383, Year 2009
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Description
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. © 2009 Blum et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2640099/bin/pntd.0000383.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2640099/bin/pntd.0000383.s002.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2640099/bin/pntd.0000383.s003.ppt
https://efashare.b-cdn.net/share/pmc/articles/PMC2640099/bin/pntd.0000383.s004.pdf
Authors & Co-Authors
Blum, Johannes A.
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Schmid, Caecilia
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Burri, Christian
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Hatz, Christoph F.R.
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Olson, Carol A.
United States
Immtech Pharmaceuticals, Inc.
Fungula, Blaise
Congo
Hôpital Evangélique de Vanga
Kazumba, Leon
Congo
Centre Neuro-psycho-pathologique
Mangoni, Patrick
Congo
Hôpital Evangélique de Vanga
Mbo, Florent
Congo
Hôpital General de Reference Bandundu
Deo, Kambau
Congo
Hôpital Evangélique de Kikongo
Mpanya, Alain
Unknown Affiliation
Dala, Amadeu
Angola, Luanda
Instituto de Combate e Controlo Das Tripanossomiases
Franco, José Ramón
Sudan, Yei
Malteser Hospital
Switzerland, Geneva
Organisation Mondiale de la Santé
Pohlig, Gabriele
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Zellweger, Michael Johannes
Switzerland, Basel
Universitätsspital Basel
Statistics
Citations: 34
Authors: 15
Affiliations: 10
Identifiers
Doi:
10.1371/journal.pntd.0000383
Research Areas
Noncommunicable Diseases
Study Locations
Angola
Congo
Sudan