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. 2022 Jun 6:117:e210172.
doi: 10.1590/0074-02760210172. eCollection 2022.

Prognosis of chronic Chagas heart disease and other pending clinical challenges

Rosália Morais Torres  1 , Dalmo Correia  2 , Maria do Carmo Pereira Nunes  1 , Walderez O Dutra  1 , André Talvani  3 , Andréa Silvestre Sousa  4   5 , Fernanda de Souza Nogueira Sardinha Mendes  5 , Maurício Ibrahim Scanavacca  6 , Cristiano Pisani  6 , Maria da Consolação Vieira Moreira  1 , Dilma do Socorro Moraes de Souza  7 , Wilson de Oliveira Junior  8 , Silvia Marinho Martins  8 , João Carlos Pinto Dias  9
Affiliations

Prognosis of chronic Chagas heart disease and other pending clinical challenges

Rosália Morais Torres et al. Mem Inst Oswaldo Cruz. .

Abstract

In this chapter, the main prognostic markers of Chagas heart disease are addressed, with an emphasis on the most recent findings and questions, establishing the basis for a broad discussion of recommendations and new approaches to managing Chagas cardiopathy. The main biological and genetic markers and the contribution of the electrocardiogram, echocardiogram and cardiac magnetic resonance are presented. We also discuss the most recent therapeutic proposals for heart failure, thromboembolism and arrhythmias, as well as current experience in heart transplantation in patients suffering from severe Chagas cardiomyopathy. The clinical and epidemiological challenges introduced by acute Chagas disease due to oral contamination are discussed. In addition, we highlight the importance of ageing and comorbidities in influencing the outcome of chronic Chagas heart disease. Finally, we discuss the importance of public policies, the vital role of funding agencies, universities, the scientific community and health professionals, and the application of new technologies in finding solutions for better management of Chagas heart disease.

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Figures

Fig. 1:
Fig. 1:. cardiac magnetic resonance with late-gadolinium enhancement with tridimensional reconstruction of the scar in a patient with Chagas cardiomyopathy showing an infero-latero-basal scar with two corridors that are potential circuits for monomorphic ventricular tachycardia (VT).
Fig. 2:
Fig. 2:. electroanatomical epicardial and endocardial voltage mapping in a patient with chronic Chagas cardiomyopathy. The endocardial voltage map shows no endocardial scar (purple colour), and the epicardial voltage map shows a large epicardial scar (red colour) on the latero-anterior and inferior walls extending from the base of the left ventricle to the apex. There are late potentials that indicate the area of slow conduction on the inferolateral portion of the scar.
See this image and copyright information in PMC

Comment in

References

    1. Chagas C. Moléstia de Carlos Chagas ou tireoidite parasitada. Nova doença humana transmitida pelo Barbeiro (Conorhinus megistus). II Conferência à Academia Nacional de Medicina em agosto de 1911. Tipografia Leuszinger. 1911
    1. Chagas C. Processos patojenicos da tripanozomiase americana. Mem Inst Oswaldo Cruz. 1916;8(2):5–36.
    1. Chagas C, Villela E. Cardiac form of American Trypanosomiasis. Mem Inst Oswaldo Cruz. 1922;14(1):5–61.
    1. Chagas E. Forma cardiaca da Trypanosomiase Americana. Memórias do Instituto Oswaldo Cruz. 1930;24(3):89–125.
    1. Dias JCP, Schofield CJ. The evolution of Chagas disease (American Trypanosomiasis) control after 90 years since Carlos Chagas discovery. Mem Inst Oswaldo Cruz. 1999;94 - PubMed