Morbidity and prognostic factors in chronic chagasic cardiopathy

Rocha, Manoel Otávio Costa; Nunes, Maria Carmo Pereira; Ribeiro, Antônio Luiz Pinho

doi:10.1590/s0074-02762009000900022

Cited by 37 publications

(24 citation statements)

References 39 publications

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“…Heart failure is usually biventricular, which is the most frequent and severe manifestation of Chagas disease and is associated with poor prognosis and high mortality rates compared to heart failure from other causes Rassi et al, 2009b). The clinical signs and symptoms are typical of heart failure and include: i) prominent apical impulse; ii) regurgitant murmurs from mitral and tricuspid valves; iii) wide splitting of the second heart sound due to right bundle branch block; and iv) accentuated pulmonic component of second heart sound due to pulmonary hypertension Rassi et al, 2009b;Rocha et al, 2009).…”

Section: Clinical Aspects Of Chagas Diseasementioning

confidence: 99%

“…In addition, they could cause quantitative alterations in adrenergic and cholinergic receptors and, consequently, potential myocardial damage due to the cardiac autonomic dysfunctions known to occur in Chagasic cardiomyopathy (Hernandez et al, 2008;Ribeiro et al, 2009a;Rocha et al, 2006a;Rocha et al, 2006b). The clinical consequence of parasympathetic denervation is the absence of mechanisms, mediated by the vagus nerve, that trigger bradycardia or tachycardia in response to transient changes in blood pressure or venous return (Miziara et al, 2006;Ribeiro et al, 2009a;Rocha et al, 2009;Rocha et al, 2006b). However, the relative importance of the parasympathetic autonomic dysfunction has been recently questioned, raising the possibility that neurohormonal activation is the main underlying mechanism of disease progression (Davila et al, 2008).…”

Section: Cardiac Disautonomiamentioning

confidence: 99%

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Chagas disease: Present status of pathogenic mechanisms and chemotherapy

et al. 2010

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There are approximately 7.8 million people in Latin America, including Chile, who suffer from Chagas disease and another 28 million who are at risk of contracting it. Chagas is caused by the flagellate protozoan Trypanosoma cruzi. It is a chronic disease, where 20%-30% of infected individuals develop severe cardiopathy, with heart failure and potentially fatal arrhythmias. Currently, Chagas disease treatment is more effective in the acute phase, but does not always produce complete parasite eradication during indeterminate and chronic phases. At present, only nifurtimox or benznidazole have been proven to be superior to new drugs being tested. Therefore, it is necessary to find alternative approaches to treatment of chronic Chagas. The current treatment may be rendered more effective by increasing the activity of anti-Chagasic drugs or by modifying the host's immune response. We have previously shown that glutathione synthesis inhibition increases nifurtimox and benznidazole activity. In addition, there is increasing evidence that cyclooxygenase inhibitors present an important effect on T. cruzi infection. Therefore, we found that aspirin reduced the intracellular infection in RAW 264.7 cells and, decreased myocarditis extension and mortality rates in mice. However, the long-term benefit of prostaglandin inhibition for Chagasic patients is still unknown.

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Section: Clinical Aspects Of Chagas Diseasementioning

confidence: 99%

Section: Cardiac Disautonomiamentioning

confidence: 99%

Chagas disease: Present status of pathogenic mechanisms and chemotherapy

et al. 2010

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“…Indeed, patients with ventricular conduction defects have higher mortality rates than infected patients without electrocardiographic abnormalities. Also, it was observed that abnormal diastolic function is related to severe myocardial damage (Rocha et al, 2009). Another survey found that there are six prognostic factors of disease development: NYHA class III or IV, cardiomegaly on chest radiography, segmental or global wall motion abnormalities on echocardiography, non-sustained ventricular tachycardia on Holter monitoring, low QRS voltage on electrocardiography, and male sex (Rassi et al, 2006).…”

Section: Prognosismentioning

confidence: 99%

“…Another survey found that there are six prognostic factors of disease development: NYHA class III or IV, cardiomegaly on chest radiography, segmental or global wall motion abnormalities on echocardiography, non-sustained ventricular tachycardia on Holter monitoring, low QRS voltage on electrocardiography, and male sex (Rassi et al, 2006). Recent studies have found that there are four echocardiographic variables associated with the disease outcome: left ventricular ejection fraction, right ventricular function, E/E' ratio, and left atrium volume (Rocha et al, 2009). Finally, the prognosis of the patient will rest on the good care and follow up of the caregivers.…”

Section: Prognosismentioning

confidence: 99%

Chagasic Cardiomyopathy

Rosas¹,

Roa²,

Zulma³

et al. 2012

Cardiomyopathies - From Basic Research to Clinical Management

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“…1,[7][8][9] The main causes of death are heart failure and sudden death, [7][8][9][10] which is related to lifethreatening arrhythmias despite antiarrhythmic therapy. [1][2][3][4][5][6][7][8][9][10] Echocardiography is important in these patients because it provides information on left ventricular (LV) dilation, systolic dysfunction, LV apical aneurysm, and mural thrombus. [7][8][9]11,12 Accurate assessment of LV filling pressures is particularly crucial for the management of heart failure.…”

mentioning

confidence: 99%