Pharmacological interventions for treating heart failure in patients with Chagas cardiomyopathy

Martí‐Carvajal, Arturo J; Hidalgo, Ricardo; Kwong, Joey S.W.

doi:10.1002/14651858.cd009077

Cited by 9 publications

(5 citation statements)

References 50 publications

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“…A meta-analysis of two trials (69 participants) found a lower proportion of all-cause mortality in the carvedilol group than in the placebo group [RR 0.69; 95% confidence interval (CI) (0.12 -3.88)], although the evidence was low quality through the GRADE assessment, and there were no conclusive results between carvedilol and placebo in terms of hospital readmissions and quality of life. (97) In contrast to the lower use of beta-blockers, patients with Chagas-HF more often receive amiodarone due to the higher risk of ventricular malignant arrhythmias. The same phenomenon has been observed with anticoagulants due to a higher frequency of cardioembolic events.…”

Section: Chronic Chagas Heart Disease and Its Therapeutic Approach: W...mentioning

confidence: 99%

Prognosis of chronic Chagas heart disease and other pending clinical challenges

Torres

Correia

Nunes

et al. 2022

Mem. Inst. Oswaldo Cruz

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Section: Chronic Chagas Heart Disease and Its Therapeutic Approach: W...mentioning

confidence: 99%

Prognosis of chronic Chagas heart disease and other pending clinical challenges

Torres

Correia

Nunes

et al. 2022

Mem. Inst. Oswaldo Cruz

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“…Instead, the drug modulated the pattern of CCL2 and IL-10 mediators. 92 An extensive meta-analysis, however, concluded that there were no conclusive data to support or reject the use of either carvedilol for treating Chagas cardiomyopathy, 93 although individual clinical trials suggest beneficial effects. 94,95 Interestingly, carvedilol alone and in combination with vitamins C and E was effective at attenuating the systemic oxidative stress in patients with Chagas heart disease, especially those less severely affected, thus suggesting the possibility of synergism between these compounds 96 and opening a window for future explorations.…”

Section: Beta-blockers and Mineralocorticoids Receptor Antagonistsmentioning

confidence: 99%

Treatment of Chronic Chagasic Patients: Is Killing the Parasite the Only Option?

Rodríguez-Angulo

2018

EMJ Cardiol

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Chagas disease is a tropical illness characterised by arrhythmias, heart failure, and eventually death. In approximately 10–30% of patients, chronic disease appears 10–30 years after infection onset. One of the biggest challenges for treatment is how to manage disease progression during the non-symptomatic phase to avoid the most life-threatening consequences of Chagas disease. The aim of this review is to evaluate the empirical rationale for an alternative therapy based on pathophysiological mechanisms that lead to chronic cardiac pathology and that have the possibility of evaluation through serological markers. The author identifies L-arginine serum levels, IL-2, and short-form Cha autoantibodies as possible markers for Chagas disease and discusses the reports regarding the therapeutic potential of amiodarone and angiotensin-converting enzyme inhibitors to modulate the electrophysiological, inflammatory, and vascular disturbances that lead to symptomatic Chagas disease. This review considers this discussion to improve the comprehension of therapeutic alternatives based on the vast literature detailing Chagas disease’s pathophysiology.

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“…Small studies have shown that neurohormonal inhibition can improve both symptoms and left ventricular function. However, a systematic review of Cochrane found very low-quality evidence for the effects of carvedilol compared with placebo for treating heart failure in people with CD [55]. On the other hand, chagasic The Role of the Clinical Cardiac Electrophysiologist in the Management of Congestive Heart Failure patients frequently have lower blood pressure and a higher incidence of bradyarrhythmias and may not tolerate target doses of angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers.…”

Section: Heart Failure In Chagas Diseasementioning

confidence: 99%

Utility of Cardiac Implantable Electronic Devices in Patients with Chagas Disease and Systolic Heart Failure

Mora¹

2017

The Role of the Clinical Cardiac Electrophysiologist in the Management of Congestive Heart Failure

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Chagas disease (CD) is the principal cause of congestive heart failure (CHF) in areas where the disease is endemic and migration has increased the likelihood of these diseases being the probable cause of CHF in other countries of the world. Sudden cardiac death (SCD) is the most common cause of death in CD (55-65%). Implantable cardioverter defibrillator (ICD) is useful in the secondary prevention of SCD, but there is less information regarding primary prevention. The evidence supporting the use of cardiac resynchronization therapy (CRT) in CHF of chagasic etiology is poor; however, one should apply current guidelines regarding the insertion of these devices in patients with Chagas disease and CHF.

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Pharmacological interventions for treating heart failure in patients with Chagas cardiomyopathy

Cited by 9 publications

References 50 publications

Prognosis of chronic Chagas heart disease and other pending clinical challenges

Prognosis of chronic Chagas heart disease and other pending clinical challenges

Treatment of Chronic Chagasic Patients: Is Killing the Parasite the Only Option?

Utility of Cardiac Implantable Electronic Devices in Patients with Chagas Disease and Systolic Heart Failure

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