Evidence map›Paper›PMID 41944184›Full record

ArticleJournal of the American Heart Association2026

Elevated Interleukin-6 Levels in Socioeconomically Disadvantaged Children With Borderline Subclinical Rheumatic Heart Disease in São Paulo, Brazil: A Prospective Cohort Study Highlighting Early Detection and Treatment Opportunities.

Carlos Eduardo de Barros Branco, Alessandra Santos Lima Gazola, Carlos Augusto Homem de Magalhães Campos, Samar Freschi de Barros, Simone Santos, Karen Francine Kohler, Marcelo Luiz Campos Vieira, Luiza Guilherme Guglielmi, Paulo Pinto Alves Campos Vieira, Samira Saady Morhy and 6 more

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Carlos Eduardo de Barros BrancoHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0002-6239-5058
Alessandra Santos Lima GazolaHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0009-0008-1486-1449
Carlos Augusto Homem de Magalhães CamposHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0003-1734-6924
Samar Freschi de BarrosHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.
Simone SantosHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.
Karen Francine KohlerHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.
Marcelo Luiz Campos VieiraHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.
Luiza Guilherme GuglielmiHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.
Paulo Pinto Alves Campos VieiraHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0002-3402-1120
Samira Saady MorhyHospital Israelita Albert Einstein São Paulo Brazil.ORCID 0000-0002-5531-9647
Ranna Santos PessoaHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0002-8328-6758
Alberto Rodolpho HüningHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0002-3076-9860
Vitor Emer Egypto RosaHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0001-6521-2870
Jorge KalilHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0001-8415-4274
Flavio TarasoutchiHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0002-9964-3289
Roney Orismar SampaioHeart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.ORCID 0000-0002-7566-2426

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSubclinical rheumatic heart disease (SCRHD) is the precursor to symptomatic disease, yet the cytokine profile of its earliest borderline stage remains uncharacterized. It is unknown whether inflammatory markers persist longitudinally in subclinical rheumatic heart disease. This study characterized the cytokine profile in borderline SCRHD at baseline and evaluated its longitudinal evolution over a 2-year period in the combined SCRHD (borderline and definitive).

methodsIn a prospective cohort study, 1026 children (5-15 years) from disadvantaged areas of São Paulo, Brazil, underwent echocardiographic screening. Participants were classified as normal, borderline SCRHD, or definite SCRHD according to World Health Organization criteria. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor-alpha, and other cytokines were measured at baseline (T0) and after 2 years (T1).

resultsThe prevalence of SCRHD was 7.6% (95% CI, 6.0%-9.2%), with 6.7% borderline (95% CI, 5.2%-8.2%) and 0.9% as definite (95% CI, 0.3%-1.5%). At baseline, IL-6 levels were significantly higher in the borderline SCRHD group compared with controls (

conclusionsBorderline SCRHD is marked by elevated IL-6 levels that last for at least 2 years, indicating a sustained proinflammatory state from the earliest detectable stage of the disease. These findings identify interleukin-6 as a potential early biomarker and therapeutic target to prevent the progression of SCRHD.

Indexed as

Interleukin-6Rheumatic Heart DiseaseAdolescentAsymptomatic DiseasesBiomarkersBrazilChildChild, PreschoolEarly DiagnosisEchocardiographyFemaleHumansMalePrevalenceProspective StudiesSocioeconomic Disparities in HealthBiomarkersIL6 protein, humanInterleukin-6Tumor Necrosis Factor-alphaborderlinecytokinesIL‐6inflammationrheumatic heart diseasesubclinicaltherapeutic strategiesTNF‐α

Identifiers

PMID41944184
PMCPMC13279056

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.