Dados do Trabalho

Título

A potential beneficial influence of Selenium treatment on cardiac function in Chagas heart disease: Results from the STCC randomized Trial

Introdução

For over 60 years, Selenium (Se) is known as an essential microelement for many biological functions, including cardiovascular homeostasis. Experimental and clinical data indicate that Se may be used as a complementary therapy to prevent and improve heart failure. We have previously shown that Se levels in chronic chagasic cardiomyopathy (CCC) decrease in severe cases.

Objetivo(s)

The aim of the present study was to estimate the efficacy and safety of Se treatment in CCC.

Material e Métodos

Here, we performed the first randomized, placebo-controlled, double-blinded clinical trial. 66 patients with CCC stages B1 (n = 54) or B2 (n = 12) were randomly assigned to receive 100 mcg/day sodium selenite (n = 32) or placebo (n = 34) for one year. LVEF changes over time and adverse effects were investigated. Trial registration number: NCT00875173.

Resultados e Conclusão

No significant differences between the two groups were observed for the primary outcome. In a subgroup analysis, statistically significant longitudinal changes were observed for mean LVEF in the stage B2 subgroup (b= +10.1; p = 0.02 for Se [n = 4] vs Pla [n = 8]). Se treatment was safe for CCC patients, and the few adverse effects observed were similarly distributed across the two groups. We showed a potential beneficial effect of Se treatment in a subset of patients with CCC with ventricular dysfunction (LVEF <45%). Despite trial limitations, this is a novel therapeutic option for mild CCC. Additionally, Se may decrease the speed of worsening cardiac function and may even improve cardiac function in patients with CCC stage B2. Se treatment did not improve cardiac function (evaluated from LVEF) in CCC. However, in the subgroup of patients at B2 stage, a potential beneficial influence of Se was observed. In conclusion, the present study elucidated that Se treatment was safe and showed a potentially beneficial effect. This new pharmaceutical/nutritional approach deserves further studies to clarify its potential use as adjuvant therapy in CCC.

Palavras-chave

Selenium, Chagas disease,Treatment