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Miranda-Arboleda AF, Agudelo JF, Correa R, Saenz G, Martinez C, Saenz LC, Ramirez JD. P295Stellate ganglion block in patients with ventricular arrhythmias, an innovative procedure that must be part of electrophysiologist therapeutic arsenal. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - J F Agudelo
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
| | - R Correa
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
| | - G Saenz
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
| | - C Martinez
- Universidad Pontificia Bolivariana, Medellin, Colombia
| | - L C Saenz
- Foundation Cardioinfantil, International Arrhythmia Center, Bogota, Colombia
| | - J D Ramirez
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
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Miranda-Arboleda AF, Agudelo JF, Correa R, Saenz G, Ramirez JD. P1137An adaptation of transseptal puncture technique for endocardial left ventricle lead placement in candidates for cardiac resynchronization therapy. Europace 2018. [DOI: 10.1093/europace/euy015.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - J F Agudelo
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
| | - R Correa
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
| | - G Saenz
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
| | - J D Ramirez
- Cardiovascular Clinic Santa Maria, Electrophysiology and arrhythmia section, Medellin, Colombia
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Bhattacharyya T, Falconar AK, Luquetti AO, Costales JA, Grijalva MJ, Lewis MD, Messenger LA, Tran TT, Ramirez JD, Guhl F, Carrasco HJ, Diosque P, Garcia L, Litvinov SV, Miles MA. Development of peptide-based lineage-specific serology for chronic Chagas disease: geographical and clinical distribution of epitope recognition. PLoS Negl Trop Dis 2014; 8:e2892. [PMID: 24852444 PMCID: PMC4031129 DOI: 10.1371/journal.pntd.0002892] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 04/09/2014] [Indexed: 11/18/2022] Open
Abstract
Background Chagas disease, caused by infection with the protozoan Trypanosoma cruzi, remains a serious public health issue in Latin America. Genetically diverse, the species is sub-divided into six lineages, known as TcI–TcVI, which have disparate geographical and ecological distributions. TcII, TcV, and TcVI are associated with severe human disease in the Southern Cone countries, whereas TcI is associated with cardiomyopathy north of the Amazon. T. cruzi persists as a chronic infection, with cardiac and/or gastrointestinal symptoms developing years or decades after initial infection. Identifying an individual's history of T. cruzi lineage infection directly by genotyping of the parasite is complicated by the low parasitaemia and sequestration in the host tissues. Methodology/Principal Findings We have applied here serology against lineage-specific epitopes of the T. cruzi surface antigen TSSA, as an indirect approach to allow identification of infecting lineage. Chagasic sera from chronic patients from a range of endemic countries were tested by ELISA against synthetic peptides representing lineage-specific TSSA epitopes bound to avidin-coated ELISA plates via a biotin labelled polyethylene glycol-glycine spacer to increase rotation and ensure each amino acid side chain could freely interact with their antibodies. 79/113 (70%) of samples from Brazil, Bolivia, and Argentina recognised the TSSA epitope common to lineages TcII/TcV/TcVI. Comparison with clinical information showed that a higher proportion of Brazilian TSSApep-II/V/VI responders had ECG abnormalities than non-responders (38% vs 17%; p<0.0001). Among northern chagasic sera 4/20 (20%) from Ecuador reacted with this peptide; 1/12 Venezuelan and 1/34 Colombian samples reacted with TSSApep-IV. In addition, a proposed TcI-specific epitope, described elsewhere, was demonstrated here to be highly conserved across lineages and therefore not applicable to lineage-specific serology. Conclusions/Significance These results demonstrate the considerable potential for synthetic peptide serology to investigate the infection history of individuals, geographical and clinical associations of T. cruzi lineages. Chagas disease remains a significant public health issue in Latin America. Caused by the single-celled parasite Trypanosoma cruzi, the main route of infection is via contact with contaminated faeces from blood-sucking triatomine bugs, but following successful insecticide spraying campaigns, congenital, food-borne, and transfusion/transplantation routes of infection have become more relevant. In the absence of successful chemotherapy, T. cruzi usually persists in the body for life, and in symptomatic cases may lead to death or debilitation by heart failure and/or gastrointestinal megasyndromes. As a species, T. cruzi displays great genetic diversity, and is subdivided into lineages called TcI - TcVI. Associating T. cruzi lineage with clinical symptoms is a key goal of Chagas disease research. Direct isolation and typing of T. cruzi from chronically infected patients is hampered by the sequestration of the parasite in host tissues. Identifying lineage-specific antibodies in serum provides an alternative approach to determining an individual's history of infection. Here, we performed lineage-specific serology using samples from a range of South American countries. We show that lineage-specific seropositivity is associated with geographical distributions and clinical outcome. These findings have wide implications for further diagnostics development and improved understanding of the epidemiology of Chagas disease.
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Affiliation(s)
- Tapan Bhattacharyya
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Alejandro O. Luquetti
- Laboratorio de Chagas, Hospital das Clinicas, Universidade Federal de Goiás, Goiânia, Goias, Brazil
| | - Jaime A. Costales
- Centro de Investigación en Enfermedades Infecciosas, Escuela de Biología, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Mario J. Grijalva
- Centro de Investigación en Enfermedades Infecciosas, Escuela de Biología, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
| | - Michael D. Lewis
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Louisa A. Messenger
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Trang T. Tran
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Juan-David Ramirez
- Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Felipe Guhl
- Centro de Investigaciones en Microbiología y Parasitología Tropical, Universidad de los Andes, Bogotá, Colombia
| | - Hernan J. Carrasco
- Universidad Central de Venezuela Instituto de Medicina Tropical, Caracas, Venezuela
| | - Patricio Diosque
- Unidad de Epidemiología Molecular, Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Salta, Salta, Argentina
| | - Lineth Garcia
- Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | | | - Michael A. Miles
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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