Effect of changas' disease on arterial blood pressure

Palmero, H A; Caeiro, T; Iosa, Daniel

doi:10.1016/0002-8703(79)90112-1

Cited by 24 publications

(13 citation statements)

References 8 publications

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“…The faulty orthostatic mechanism in all our chagasic patients and the progressive tendency to sinus bradycardia as can be observed in this study, with the presence of arterial hypotension and the decreased prevalence of arterial hypertension among our chagasic patients previously reported [18], could in part be explained by decreased sympathetic activity, which differs from the predominant decreased parasympathetic activity found in Brazilian chagasic patients.…”

Section: Discussionsupporting

confidence: 55%

Distinctive abnormal responses to tilting test in chronic chagas' disease

1980

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The purpose of this study was to investigate the sympathetic nervous system function in 34 patients with chronic Chagas' disease. The tilting test was selected as an appropriate means to assess the adrenergic system function. Our results demonstrate that (a) all chagasics respond with a significantly smaller rise in diastolic blood pressure (0-3.8 mmHg) than normal subjects (9-12 mmHg), when submitted to the tilting test and (b) chagasic patients with heart failure have a significantly lower heart rate than normal subjects and nonchagasic heart failure patients (P < 0.05 and 0.001, respectively). With these results we may speculate that the damage in chronic Chagas' disease should be located in the sympathetic pathway. Therefore, the faulty orthostatic mechanism would be the consequence of a diminished adrenergic activity, with a defective arteriolar vasoconstriction and a decreased basal heart rate. At the same time we note that our results differ from the results of similar tests performed on the same kind of chagasic patients in Brazil, where a predominantly decreased parasymphathetic activity has been demonstrated.

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Section: Discussionsupporting

confidence: 55%

Distinctive abnormal responses to tilting test in chronic chagas' disease

1980

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“…8 A low-sodium diet could potentially contribute to the appearance of abnormal sodium serum levels because such patients have increased urinary sodium losses. Furthermore, because systemic arterial pressure is usually lower than that observed in Chagas disease patients, 27 patients with CHF secondary to Chagas cardiomyopathy cannot tolerate target doses of angiotensin converting enzyme inhibitors (ACEI) because of systemic arterial hypotension. 28 Therefore, it seems to be prudent not to recommend sodium restriction in the dietetic regimen of all patients with Chagas disease heart failure.…”

Section: Non-pharmacological Treatmentmentioning

confidence: 99%

The treatment of chronic heart failure secondary to Chagas cardiomyopathy in the contemporary era

Bestetti¹,

Daniel²

2016

ICFJ

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<p>Chronic Heart Failure (CHF) affects about half patients with Chagas cardiomyopathy. Outcome of CHF secondary to Chagas cardiomyopathy is relentless with an annual mortality approaching 20%, which is higher than that observed in non-Chagas disease heart failure. The pathophysiology of Chagas disease is similar to that found in non-Chagas disease heart failure with a marked activation of the neurohormonal system. No randomized trial has been conducted in patients with Chagas cardiomyopathy with CHF to assess the effect of a drug on mortality of such patients. Therefore, the treatment of CHF secondary to Chagas cardiomyopathy relies on drugs prescribed to patients with non-Chagas disease heart failure<strong>. </strong>Patients with Chagas disease heart failure have been classified into stages A to D according to the American College of Cardiology/American Heart Association. Little can be done to patients in the stage A of CHF, except for treatment of comorbidities. In patients in the stage B of CHF, aldosterone receptor antagonist, angiotensin converting enzyme inhibitors (ACEI), and Betablockers (BB) can be indicated. In patients in the stage C of CHF, the same drugs are of value. In addition, diuretics, digoxin, angiotensin receptor blockers to patients intolerant to ACEI have also been used. Cardiac Resynchronization Therapy and Implantable Cardioverter Defibrillator may have indications similar to that of non-Chagas disease patients. In stage D of CHF, heart transplantation is a valid option for patients with this condition. </p>

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“…According to these studies, the deficient adrenergic vasomotor regulation, taken together with frequently reduced levels of basal heart rate, may explain the significantly lower systemic tension levels detected in the chagasic population when compared to normal groups (60).…”

Section: Functional Repercussions Of Cardiovascular Sympathetic Damagementioning

confidence: 99%

Functional alterations of the autonomic nervous system in Chagas' heart disease

Marin-Neto

1995

Sao Paulo Med. J.

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Several independent pathological studies in experimental models and in human beings showed conspicuous autonomic denervation in Chagas' disease. In spite of the inherently complex structural organization of the autonomic nervous system, the parasympathetic and sympathetic divisions are involved, as shown by many functional studies. Hence, Chagas' disease represents a unique model of impairment of the autonomic control of the heart, in absence of the nonspecific effects of cardiac failure. An important limitation of the studies thus far carried out is the lack of a better knowledge of the molecular biology characteristics of different strains of T. cruzi. This could explain some geographical discrepancies found in the clinical behaviour of Chagas' disease, and contribute to a better understanding of its pathophysiology.

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Effect of changas' disease on arterial blood pressure

Cited by 24 publications

References 8 publications

Distinctive abnormal responses to tilting test in chronic chagas' disease

Distinctive abnormal responses to tilting test in chronic chagas' disease

The treatment of chronic heart failure secondary to Chagas cardiomyopathy in the contemporary era

Functional alterations of the autonomic nervous system in Chagas' heart disease

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