Chagas' Heart Disease

Rassi, Anis; Little, William C.

doi:10.1002/clc.4960231205

Cited by 264 publications

(67 citation statements)

References 48 publications

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“…Because the evolution of Chagas cardiomyopathy occurs over multiple decades, a snapshot survey of the prevalence of cardiac abnormalities, especially in a young population, will reveal relatively few severe cases [8, 21]. We found few participants with high grade conduction system disease or dilated cardiomyopathy, and these abnormalities tended to occur in the same individuals.…”

Section: Resultsmentioning

confidence: 90%

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Electrocardiographic and Echocardiographic Abnormalities in Chagas Disease: Findings in Residents of Rural Bolivian Communities Hyperendemic for Chagas Disease

Fernández

Nunes

Clark

et al. 2015

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Background Chagas disease is a neglected and preventable tropical disease that causes significant cardiac morbidity and mortality in Latin America. Our objective in this study was to describe cardiac findings among inhabitants of rural communities of the Bolivian Chaco. Methods The cardiac study drew participants from an epidemiologic study in 7 indigenous Guarani communities. All infected participants 10 years or older were asked to undergo a brief physical examination and 12-lead electrocardiogram. A subset had echocardiograms (ECGs). ECGs and echocardiograms were read by one or more cardiologists. Results Of 1137 residents 10 years or older, 753 (66.2%) had T. cruzi infection. Cardiac evaluations were performed for 398 infected participants 10 years or older. Fifty-five (13.8%) participants had one or more ECG abnormality suggestive of Chagas cardiomyopathy. The most frequent abnormalities were bundle branch blocks in 42 (11.3%), followed by rhythm disturbances or ventricular ectopy in 13 (3.3%) and atrioventricular blocks (AVB) in 10 (2.6%) participants. The prevalence of any abnormality rose from 1.1% among those 10-19 years old to 14.2%, 17.3% and 26.4% among those 20-39, 40-59 and older than 60 years, respectively. First degree AVB was seen most frequently in participants 60 years or older, but the 4 patients with 3rd degree AVB were all under 50 years old. Eighteen and two participants had a left ventricular ejection fraction of 40-54% and <40%, respectively. An increasing number of ECG abnormalities was associated with progressively larger left ventricular end-diastolic dimensions and lower left ventricular ejection fraction. Conclusions We found a high prevalence of ECG abnormalities and substantial evidence of Chagas cardiomyopathy. Programs to improve access to basic cardiac care (annual ECGs, antiarrhythmics, pacemakers) could have an immediate impact on morbidity and mortality in these highly endemic communities.

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Section: Resultsmentioning

confidence: 90%

“…Later manifestations include left ventricular systolic dysfunction, apical aneurysms, high-degree atrioventricular block, and sustained and non-sustained ventricular tachycardia [8]. Late cardiac manifestations are associated with high short-term mortality risk [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic and Echocardiographic Abnormalities in Chagas Disease: Findings in Residents of Rural Bolivian Communities Hyperendemic for Chagas Disease

Fernández

Nunes

Clark

et al. 2015

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“…megacolon, megaesophagus, mega stomach, mega duodenum, mega jejunum, mega gallbladder and mega choledochus. The megasyndromes develops in about 10% to 15% of chronically infected patients [17,18]. Patients with megaesophagus also have an increased prevalence of cancer of the esophagus.…”

Section: The Relationship Between Chagas Disease and Cancermentioning

confidence: 99%

New Treatments for Chagas Disease and the Relationship between Chagasic Patients and Cancers

Oliveira¹,

Mendes²,

Almeida³

et al. 2014

CRJ

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Abstract:Chagas disease is an infectious illness with a broad distribution throughout the South American and African continents, importantly influencing human morbidity and mortality and a controversial relationship with the onset of cancers, especially of the gastrointestinal tract system. In addition, it is listed by the World Health Organization (WHO) as one ofthe most neglected tropical diseases. Although Chagas disease (CD) was discovered more than 100 years ago, the existing therapies show low efficacy and serious side effects and developing safer and more effective drugs remains a hard challenge. Thus, this review highlights the main, novel and promising treatments against Trypanosoma cruzi, including biomacromolecules, natural products, vaccines, and metabolic pathway targets and highlights a worsening of esophageal cancer prognosis in chagasic patients. Moreover, we also discuss the perspectives of obtaining original optimized drugs that take advantage of organic and inorganic medicinal chemistry advances, as well as molecular modeling and biotechnology.

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“…Infection with the protozoan parasite Trypanosoma cruzi causes Chagas' disease, a major cause of acute myocarditis and chronic cardiomyopathy in endemic areas of Mexico and Central and South America (Tanowitz et al 1992;World Health Organisation 1997;Rassi et al 2000;Romano et al 2001). Chagas' disease has also been reported among immigrants in North America and Europe and is considered to be an opportunistic infection in immunocompromised individuals (Kirchhoff et al 2004).…”

Section: Introductionmentioning

confidence: 98%

Effects of early and late verapamil administration on the development of cardiomyopathy in experimental chronic Trypanosoma cruzi (Brazil strain) infection

Souza

Tanowitz

Chandra³

et al. 2004

Parasitology Research

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Chagas' disease, caused by Trypanosoma cruzi, leads to acute myocarditis and chronic cardiomyopathy. Myocardial structure and function were evaluated in T. cruzi (Brazil strain)-infected CD1 mice by histopathology, cardiac gated magnetic resonance imaging (MRI) and transthoracic echocardiography. There was a significant reduction in inflammation and fibrosis in infected mice treated early in infection. In mice treated late in infection, echocardiography revealed a significant increase in the end diastolic diameter and a decrease in percent fractional shortening and relative wall thickness. MRI revealed an increase in the right ventricular internal dimension. These findings, consistent with a dilated cardiomyopathy, were ameliorated in the early but not in the late treatment group, demonstrating that late treatment with verapamil is ineffective in reversing the development of chagasic cardiomyopathy in chronically infected mice. Our data underscore the hypothesis that early events determine the progression to cardiomyopathy and that early treatment with verapamil can prevent such progression.

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Chagas' Heart Disease

Cited by 264 publications

References 48 publications

Electrocardiographic and Echocardiographic Abnormalities in Chagas Disease: Findings in Residents of Rural Bolivian Communities Hyperendemic for Chagas Disease

Electrocardiographic and Echocardiographic Abnormalities in Chagas Disease: Findings in Residents of Rural Bolivian Communities Hyperendemic for Chagas Disease

New Treatments for Chagas Disease and the Relationship between Chagasic Patients and Cancers

Effects of early and late verapamil administration on the development of cardiomyopathy in experimental chronic Trypanosoma cruzi (Brazil strain) infection

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