{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T05:35:56Z","timestamp":1770788156313,"version":"3.50.0"},"reference-count":60,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Context<\/jats:italic>\n                    .\u2014Chronic Chagas disease (15 million patients; annual incidence, 40\u200a000 patients; annual mortality, 12\u200a500 patients) is the most serious parasitic disease in Latin America. Between 10 and 30\u00a0years after infection, 30% of patients with Chagas disease develop heart injury, which is the main reason for its high mortality. Consequently, frequent cardiac diagnostics are required for patients with Chagas disease.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    .\u2014To minimize time-intensive and cost-intensive diagnostics, such as electrocardiography, echocardiography, and radiologic imaging, we tested the effect of measuring serum cardiac troponin T (cTnT) with a highly sensitive assay. To indicate the pathophysiologic background for cTnT release in Chagas heart injury, inflammation markers, such as C-reactive protein and interleukin 6, were measured in parallel.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design<\/jats:italic>\n                    .\u2014Serum cTnT was measured in 26 healthy subjects and in 179 patients with chronic Chagas disease who were asymptomatic (indeterminate stage, n \u200a=\u200a 86), who were suffering from cardiomyopathy with or without megacolon (n \u200a=\u200a 71), or who were suffering from megacolon exclusively (n \u200a=\u200a 22).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    .\u2014Serum cTnT was significantly higher in patients with cardiomyopathy with or without megacolon than in healthy subjects, asymptomatic subjects, and patients with megacolon, and the cTnT value was correlated with the severity of the cardiomyopathy. The lower limit of detection for the highly sensitive assay (3\u00a0ng\/L) was best at distinguishing patients with, and without, heart injury. C-reactive protein and interleukin 6 were found to parallel cTnT changes in both the different Chagas groups and the cardiomyopathy groups separated by disease severity.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    .\u2014Highly sensitive cTnT measurement has the potential to contribute to diagnosis and monitoring of heart injury in patients with chronic Chagas disease. The highly sensitive assay of cTnT release seems to be related to Chagas heart disease\u2013specific inflammation.\n                  <\/jats:p>","DOI":"10.5858\/135.2.243","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T12:59:14Z","timestamp":1613134754000},"page":"243-248","source":"Crossref","is-referenced-by-count":26,"title":["Cardiac Troponin T Measured With a Highly Sensitive Assay for Diagnosis and Monitoring of Heart Injury in Chronic Chagas Disease"],"prefix":"10.5858","volume":"135","author":[{"given":"Silvia Gilka Mu\u00f1oz","family":"Saravia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annekathrin","family":"Haberland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Bartel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul","family":"Araujo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregorio","family":"Valda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana Duchen","family":"Reynaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan Diaz","family":"Ramirez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian C","family":"Borges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd","family":"Wallukat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingolf","family":"Schimke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"issue":"2","key":"i1543-2165-135-2-243-b01","series-title":"Rev Soc Bras Med Trop","first-page":"193","article-title":"Problems and perspectives for Chagas disease control: in search of a realistic analysis","volume":"41","author":"Dias\n              JC,","year":"2008","unstructured":"Dias\n              JC, \n            \n              Prata\n              A, \n            \n              Correia\n              D. \n          \n          Problems and perspectives for Chagas disease control: in search of a realistic analysis. 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Prog Cardiovasc Dis. 2004;47(3):177\u2013188."},{"issue":"1","key":"i1543-2165-135-2-243-b08","series-title":"Clin Chem","first-page":"101","article-title":"Reference population and marathon runner sera assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and I assays","volume":"55","author":"Mingels\n              A,","year":"2009","unstructured":"Mingels\n              A, \n            \n              Jacobs\n              L, \n            \n              Michielsen\n              E, \n            \n              Swaanenburg\n              J, \n            \n              Wodzig\n              W, \n            \n              van Dieijen-Visser\n              M. \n          \n          Reference population and marathon runner sera assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and I assays. Clin Chem. 2009;55(1):101\u2013108."},{"issue":"2","key":"i1543-2165-135-2-243-b09","series-title":"Cardiovasc Toxicol","first-page":"87","article-title":"Elevation in cardiac troponin measurements: false false\u2013positives","volume":"1","author":"Jaffe\n              AS.","year":"2001","unstructured":"Jaffe\n              AS. \n          \n          Elevation in cardiac troponin measurements: false false\u2013positives. Cardiovasc Toxicol. 2001;1(2):87\u201392."},{"issue":"9","key":"i1543-2165-135-2-243-b10","series-title":"Ann Intern Med","first-page":"786","article-title":"Narrative review: alternative causes for elevated cardiac troponin levels when acute coronary syndromes are excluded","volume":"142","author":"Jeremias\n              A,","year":"2005","unstructured":"Jeremias\n              A, \n            \n              Gibson\n              CM. \n          \n          Narrative review: alternative causes for elevated cardiac troponin levels when acute coronary syndromes are excluded. Ann Intern Med. 2005;142(9):786\u2013791."},{"issue":"7","key":"i1543-2165-135-2-243-b11","series-title":"Rev Esp Cardiol","first-page":"742","article-title":"Serum troponin T in patients with chronic Chagas disease","volume":"56","author":"Basquiera\n              AL,","year":"2003","unstructured":"Basquiera\n              AL, \n            \n              Capra\n              R, \n            \n              Omelianiuk\n              M, \n            \n              Amuch\u00e1stegui\n              M, \n            \n              Madoery\n              RJ, \n            \n              Salomone\n              OA. \n          \n          Serum troponin T in patients with chronic Chagas disease. Rev Esp Cardiol. 2003;56(7):742\u2013744."},{"issue":"6","key":"i1543-2165-135-2-243-b12","series-title":"Braz J Infect Dis","first-page":"358","article-title":"Troponin in Chagas disease","volume":"7","author":"Arias\n              R,","year":"2003","unstructured":"Arias\n              R, \n            \n              Bastos\n              C, \n            \n              Mota\n              G. \n            et al. \n          Troponin in Chagas disease. Braz J Infect Dis. 2003;7(6):358\u2013359."},{"issue":"2","key":"i1543-2165-135-2-243-b13","series-title":"Arq Bras Cardiol","first-page":"182","article-title":"Positive troponin T in a chagasic patient with sustained ventricular tachycardia and no obstructive lesions on cine coronary angiography [in Portuguese]","volume":"84","author":"Machado\n              MN,","year":"2005","unstructured":"Machado\n              MN, \n            \n              Suzuki\n              FA, \n            \n              Mouco\n              OC, \n            \n              Hernandes\n              ME, \n            \n              Lemos\n              MA, \n            \n              Maia\n              LN. \n          \n          Positive troponin T in a chagasic patient with sustained ventricular tachycardia and no obstructive lesions on cine coronary angiography [in Portuguese]. Arq Bras Cardiol. 2005;84(2):182\u2013184."},{"issue":"11","key":"i1543-2165-135-2-243-b14","series-title":"Circulation","first-page":"1242","article-title":"Prognostic value of very low plasma concentrations of troponin T in patients with stable chronic heart failure","volume":"116","author":"Latini\n              R,","year":"2007","unstructured":"Latini\n              R, \n            \n              Masson\n              S, \n            \n              Anand\n              IS. \n            et al. \n          Prognostic value of very low plasma concentrations of troponin T in patients with stable chronic heart failure. Circulation. 2007;116(11):1242\u20131249."},{"issue":"11","key":"i1543-2165-135-2-243-b15","series-title":"Pacing Clin Electrophysiol","first-page":"1174","article-title":"Biochemical evidence of cardiac damage following transvenous implantation of a permanent antibradicardia pacemaker lead","volume":"28","author":"Nikolaou\n              NI,","year":"2005","unstructured":"Nikolaou\n              NI, \n            \n              Spanodimos\n              SG, \n            \n              Tsaglis\n              EP. \n            et al. \n          Biochemical evidence of cardiac damage following transvenous implantation of a permanent antibradicardia pacemaker lead. Pacing Clin Electrophysiol. 2005;28(11):1174\u20131181."},{"issue":"8","key":"i1543-2165-135-2-243-b16","series-title":"Am J Cardiol","first-page":"1061","article-title":"Troponin I rise after pacemaker implantation at the time of \u201cuniversal definition of myocardial infarction.\u201d","volume":"103","author":"Martignani\n              C,","year":"2009","unstructured":"Martignani\n              C, \n            \n              Diemberger\n              I, \n            \n              Biffi\n              M. \n            et al. \n          Troponin I rise after pacemaker implantation at the time of \u201cuniversal definition of myocardial infarction.\u201d. Am J Cardiol. 2009;103(8):1061\u20131065."},{"issue":"9","key":"i1543-2165-135-2-243-b17","series-title":"Acta Anaesthesiol Scand","first-page":"1071","article-title":"Troponin T-values provide long-term prognosis in elderly patients undergoing non-cardiac surgery","volume":"48","author":"Oscarsson\n              A,","year":"2004","unstructured":"Oscarsson\n              A, \n            \n              Eintrei\n              C, \n            \n              Ansk\u00e4r\n              S. \n            et al. \n          Troponin T-values provide long-term prognosis in elderly patients undergoing non-cardiac surgery. Acta Anaesthesiol Scand. 2004;48(9):1071\u20131079."},{"issue":"8","key":"i1543-2165-135-2-243-b18","series-title":"Clin Chem","first-page":"1614","article-title":"Importance of low concentrations of cardiac troponins","volume":"52","author":"Schulz\n              O,","year":"2006","unstructured":"Schulz\n              O, \n            \n              Kirpal\n              K, \n            \n              Stein\n              J. \n            et al. \n          Importance of low concentrations of cardiac troponins. 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Am J Cardiol. 2007;100(5):764\u2013769."},{"issue":"6","key":"i1543-2165-135-2-243-b20","series-title":"Mem Inst Oswaldo Cruz","first-page":"645","article-title":"Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy","volume":"99","author":"Talvani\n              A,","year":"2004","unstructured":"Talvani\n              A, \n            \n              Rocha\n              MO, \n            \n              Cogan\n              J. \n            et al. \n          Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy. 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Prog Cardiovasc Dis. 2004;47(3):177\u2013188."},{"issue":"1","key":"i1543-2165-135-2-243-b08","series-title":"Clin Chem","first-page":"101","article-title":"Reference population and marathon runner sera assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and I assays","volume":"55","author":"Mingels\n              A,","year":"2009","unstructured":"Mingels\n              A, \n            \n              Jacobs\n              L, \n            \n              Michielsen\n              E, \n            \n              Swaanenburg\n              J, \n            \n              Wodzig\n              W, \n            \n              van Dieijen-Visser\n              M. \n          \n          Reference population and marathon runner sera assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and I assays. Clin Chem. 2009;55(1):101\u2013108."},{"issue":"2","key":"i1543-2165-135-2-243-b09","series-title":"Cardiovasc Toxicol","first-page":"87","article-title":"Elevation in cardiac troponin measurements: false false\u2013positives","volume":"1","author":"Jaffe\n              AS.","year":"2001","unstructured":"Jaffe\n              AS. \n          \n          Elevation in cardiac troponin measurements: false false\u2013positives. Cardiovasc Toxicol. 2001;1(2):87\u201392."},{"issue":"9","key":"i1543-2165-135-2-243-b10","series-title":"Ann Intern Med","first-page":"786","article-title":"Narrative review: alternative causes for elevated cardiac troponin levels when acute coronary syndromes are excluded","volume":"142","author":"Jeremias\n              A,","year":"2005","unstructured":"Jeremias\n              A, \n            \n              Gibson\n              CM. \n          \n          Narrative review: alternative causes for elevated cardiac troponin levels when acute coronary syndromes are excluded. 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Circulation. 2007;116(11):1242\u20131249."},{"issue":"11","key":"i1543-2165-135-2-243-b15","series-title":"Pacing Clin Electrophysiol","first-page":"1174","article-title":"Biochemical evidence of cardiac damage following transvenous implantation of a permanent antibradicardia pacemaker lead","volume":"28","author":"Nikolaou\n              NI,","year":"2005","unstructured":"Nikolaou\n              NI, \n            \n              Spanodimos\n              SG, \n            \n              Tsaglis\n              EP. \n            et al. \n          Biochemical evidence of cardiac damage following transvenous implantation of a permanent antibradicardia pacemaker lead. Pacing Clin Electrophysiol. 2005;28(11):1174\u20131181."},{"issue":"8","key":"i1543-2165-135-2-243-b16","series-title":"Am J Cardiol","first-page":"1061","article-title":"Troponin I rise after pacemaker implantation at the time of \u201cuniversal definition of myocardial infarction.\u201d","volume":"103","author":"Martignani\n              C,","year":"2009","unstructured":"Martignani\n              C, \n            \n              Diemberger\n              I, \n            \n              Biffi\n              M. \n            et al. \n          Troponin I rise after pacemaker implantation at the time of \u201cuniversal definition of myocardial infarction.\u201d. Am J Cardiol. 2009;103(8):1061\u20131065."},{"issue":"9","key":"i1543-2165-135-2-243-b17","series-title":"Acta Anaesthesiol Scand","first-page":"1071","article-title":"Troponin T-values provide long-term prognosis in elderly patients undergoing non-cardiac surgery","volume":"48","author":"Oscarsson\n              A,","year":"2004","unstructured":"Oscarsson\n              A, \n            \n              Eintrei\n              C, \n            \n              Ansk\u00e4r\n              S. \n            et al. \n          Troponin T-values provide long-term prognosis in elderly patients undergoing non-cardiac surgery. 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