Aspirin plus verapamil relieves angina and perfusion abnormalities in patients with coronary microvascular dysfunction and Chagas disease: a pilot non-randomized study

Pavão, Rafael Brolio; Moreira, Henrique T.; Pintya, Antonio Osvaldo; Haddad, Jorge; Badran, André Vannuchi; Lima-Filho, Moysés de Oliveira; Lago, Igor Matos; Chierice, João Reynaldo Abbud; Schmidt, André; Marin‐Neto, José Antônio

doi:10.1590/0037-8682-0181-2021

Cited by 8 publications

(5 citation statements)

References 53 publications

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“…121,122 A preliminary study of aspirin plus verapamil in patients with CCM who had chest pain and evidence of MPD demonstrated a significant reduction of reversible perfusion defects and improvement of quality of life scores. 123 These results have prompted further investigation into the role of vasodilation in a patient population, with an ongoing randomized controlled trial testing sildenafil on MPD in patients with CCM with normal epicardial coronary arteries. 124…”

Section: Evidence Of Microvascular Remodeling Derangements From Clini...mentioning

confidence: 99%

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Roman-Campos,

Marin-Neto,

Santos-Miranda

et al. 2024

Circulation Research

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Chagas cardiomyopathy caused by infection with the intracellular parasite Trypanosoma cruzi is the most common and severe expression of human Chagas disease. Heart failure, systemic and pulmonary thromboembolism, arrhythmia, and sudden cardiac death are the principal clinical manifestations of Chagas cardiomyopathy. Ventricular arrhythmias contribute significantly to morbidity and mortality and are the major cause of sudden cardiac death. Significant gaps still exist in the understanding of the pathogenesis mechanisms underlying the arrhythmogenic manifestations of Chagas cardiomyopathy. This article will review the data from experimental studies and translate those findings to draw hypotheses about clinical observations. Human- and animal-based studies at molecular, cellular, tissue, and organ levels suggest 5 main pillars of remodeling caused by the interaction of host and parasite: immunologic, electrical, autonomic, microvascular, and contractile. Integrating these 5 remodeling processes will bring insights into the current knowledge in the field, highlighting some key features for future management of this arrhythmogenic disease.

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Section: Evidence Of Microvascular Remodeling Derangements From Clini...mentioning

confidence: 99%

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Roman-Campos,

Marin-Neto,

Santos-Miranda

et al. 2024

Circulation Research

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Section: 2 Métodos Diagnósticos De Alterações Cardíacas Estruturais E...unclassified

“… 446 In addition, researchers have reported improvement in symptoms and myocardial perfusion when patients with CCCD were treated with platelet inhibitors and microvascular vasodilators, the first demonstration of benefit achieved in this context. 447 …”

Section: 210 Cardiac Catheterizationmentioning

confidence: 99%

“…446 Além disso, esses investigadores relataram melhora sintomática e da perfusão miocárdica quando os pacientes com CCDC foram tratados com inibidor plaquetário e vasodilatador microvascular, a primeira demonstração de benefício alcançado nesse contexto. 447 O cateterismo cardíaco pode ser empregado, portanto, quando pacientes com média ou alta probabilidade de doença arterial coronariana obstrutiva apresentam dor anginosa típica e/ou múltiplos fatores de risco para doença aterosclerótica ou têm grande área isquêmica demonstrada em exames não invasivos. Durante o estudo hemodinâmico, a ventriculografia de contraste radiológico, por sua elevada resolução temporal e espacial, pode indigitar pequenos aneurismas apicais e/ ou outras alterações segmentares na contração ventricular, que poderiam não ser detectadas por outros métodos de imageamento.…”

Section: Cateterismo Cardíacounclassified

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Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

Marin-Neto¹,

Rassi²,

Oliveira³

et al. 2023

Arquivos Brasileiros De Cardiologia

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“…The pathophysiology of microvascular CAD in patients with CCD is not fully understood at this time; however, abnormalities in the microcirculation caused by vasospasm and platelet aggregation associated with inflammation and autonomic dysfunction have been postulated ( 17 , 18 ). In this regard, a 3-month treatment with verapamil (80 mg/bid) and acetylsalicylic acid (100 mg/once a day) reduced the burden of ischemic episodes in patients with CCHD with microvascular CAD ( 19 ).…”

Section: Cardiovascular Diseases Managementmentioning

confidence: 99%

Management of Cardiovascular Disease in Patients With COVID-19 and Chronic Chagas Disease: Implications to Prevent a Scourge Still Larger

Bestetti

Bocchi²,

Bestetti³

et al. 2022

Front. Med.

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Cardiovascular diseases (CVD) are the most important cause of morbidity and mortality in the general population. Because the high prevalence of COVID-19 and chronic Chagas disease (CCD) where the latter is endemic, all such diseases will likely be observed in the same patient. While COVID-19 can provoke generalized endotheliitis, which can lead to a cytokine storm and a hyper-coagulable state culminating into in-site and at a distance thrombosis. Therefore, small-vessel coronary artery disease (CAD), cerebrovascular disease, thromboembolism, and arrhythmias are prominent findings in COVID-19. In CCD, small-vessel CAD, cardioembolic stroke, pulmonary embolism, heart failure and arrhythmias are frequently observed as a result of a similar but less intense mechanism. Consequently, the association of CCD and COVID-19 will likely increase the incidence of CVD. Thus, doctors on the frontline should be on the alert for this diagnostic possibility so that the proper treatment can be given without any delay.

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Aspirin plus verapamil relieves angina and perfusion abnormalities in patients with coronary microvascular dysfunction and Chagas disease: a pilot non-randomized study

Cited by 8 publications

References 53 publications

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

Management of Cardiovascular Disease in Patients With COVID-19 and Chronic Chagas Disease: Implications to Prevent a Scourge Still Larger

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