Chagas Disease and Heart Failure: An Expanding Issue Worldwide

Abstract

Chagas disease, originally a South American endemic health problem, is expanding worldwide because of people migration. Its main impact is on the cardiovascular system, producing myocardial damage that frequently results in heart failure. Pathogenic pathways are mainly related to inmunoinflamatory reactions in the myocardium and, less frequently, in the gastrointestinal tract. The heart usually shows fibrosis, producing dilatation and damage of the electrogenic cardiac system. These changes result in cardiomyopathy with heart failure and frequent cardiac arrhythmias and heart blocks. Diagnosis of the disease must include a lab test to detect the parasite or its immune reactions and the usual techniques to evaluate cardiac function. Therapeutic management of Chagas heart failure does not differ significantly from the most common treatment for dilated cardiomyopathy, with special focus on arrhythmias and several degrees of heart block. Heart transplantation is reserved for end-stage cases. Major international scientific organisations are delivering recommendations for prevention and early diagnosis. This article provides an analysis of epidemiology, prevention, treatment and the relationship between Chagas disease and heart failure.

IL-10-Dependent and -Independent Mechanisms Are Involved in the Cardiac Pathology Modulation Mediated by Fenofibrate in an Experimental Model of Chagas Heart Disease

“…An ongoing inflammatory process dysregulated by yet unknown factors, associated with unsuccessful parasite control, leads to severe consequences in 30-40% of infected people late during the chronic phase of which Chronic Chagasic Cardiomyopathy (CCC), a form of dilated cardiomyopathy, is the most frequent consequence (13,14). Its main features are the development of cardiac conduction system anomalies leading to arrhythmia, microvascular alterations leading to thromboembolism, and inflammatory processes that promote heart muscle fibrosis.…”

Differentially expressed lnc‐NOS2P3‐miR‐939‐5p axis in chronic heart failure inhibits myocardial and endothelial cells apoptosis via iNOS/TNFα pathway

“…As more and more patients survive their initial cardiovascular diseases, chronic heart failure (CHF) becomes the leading cause of elderly hospitalization and death worldwide 1 . Therapeutic strategies improvements didn’t increase CHF survival rate effectively 2 .…”

Remarkable genetic diversity of Trypanosoma cruzi and Trypanosoma rangeli in two localities of southern Ecuador identified via deep sequencing of mini-exon gene amplicons

“…Chagas disease (CD) is caused by the kinetoplastid hemoflagellate parasite Trypanosoma cruzi and affects 6-7 million people worldwide [1]. This neglected disease is endemic to Latin America, where it poses risk of infection for > 65 million people and kills an estimated 50,000 every year [2].…”