CORRELATION BETWEEN ADRENAL CENTRAL VEIN PARASITISM AND HEART FIBROSIS IN CHRONIC CHAGASIC MYOCARDITIS

The correlation between Trypanosoma cruzi parasitism of the adrenal ce ntral vein (ACV) wall and fibrous connective tissue neoformation in th e left ventricular myocardium (LVM) of patients with chronic Chagas' d isease who were autopsied was evaluated using the following procedures : 1) a comparison of the incidence of fibrosis in the LVM among 18 cha gasic patients with ACV parasitism and 18 individuals without phlebopa rasitism; 2) a determination of fibrosis intensity in the LVM in 12 ca ses with ACV parasites and in 12 cases without phleboparasitism, match ed with respect to age, sex, race, and anatomoclinical form of the dis ease (indeterminant, cardiac, and digestive forms); and 3) in the case s with ACV parasitism, a calculation of Pearson's correlation coeffici ent between T. cruzi nests in the vessel and the intensity of fibrous connective tissue neoformation in the LVM. Among chagasic individuals with adrenal phleboparasitism, there was an increased incidence and in tensity of fibrous connective tissue neoformation in the LVM, both hig hly significant, compared with patients without adrenal phleboparasiti sm. Furthermore, then was a positive, though nonsignificant, correlati on (r = +0.19) between the density of nests in the ACV and the intensi ty of myocardial fibrosis. These results are consistent with previous data showing a higher intensity of the leukocyte exudate in the LVM an d increased heart weight in individuals with T. cruzi nests in the ACV , suggesting a role of parasitism at that site in terms of the develop ment of chronic chagasic cardiopathy.