Blood Pressure, Metabolic and Autonomic Responses to Insulin and Intralipid (R) Infusion in Chagasic Patients

Background: Intralipid (R) and heparin infusion results in increased blood pressure and autonomic abnormalities in normal and hypertensive individuals. Objective: To evaluate insulin sensitivity and the impact of Intralipid (R) and heparin (ILH) infusion on hemodynamic, metabolic, and autonomic response in patients with the indeterminate form of Chagas' disease. Methods: Twelve patients with the indeterminate form of Chagas' disease and 12 healthy volunteers were evaluated. Results: Baseline blood pressure and heart rate were similar in both groups. Plasma noradrenaline levels were slightly increased in the Chagas' group. After insulin tolerance testing (ITT), a significant decline was noted in glucose in both groups. ILH infusion resulted in increased blood pressure in both groups, but there was no significant change in plasma noradrenaline. The low-frequency component (LF) was similar and similarly increased in both groups. The high-frequency component (HF) was lower in the Chagas' group. Conclusion: Patients with the indeterminate form of Chagas' disease had increased sympathetic activity at baseline and impaired response to insulin. They also had a lower high-frequency component and impaired baroreflex sensitivity at baseline and during Intralipid (R) and heparin infusion. (Arq Bras Cardiol 2012;98(3):225-233)FAPESPFAPES