Chagas Cardiomyopathy and Myocardial Sympathetic Denervation

AbstractPurpose of ReviewMore than a century since its discovery, the pathogenesis of Chagas heart disease (CHD) remains incompletely understood. The role of derangements in the autonomic control of the heart in triggering malignant arrhythmia before the appearance of contractile ventricular impairment was reviewed.Recent FindingsAlthough previous investigations had demonstrated the anatomical and functional consequences of parasympathetic dysautonomia upon the heart rate control, only recently, coronary microvascular disturbances and sympathetic denervation at the ventricular level have been reported in patients and experimental models of CHD, exploring with nuclear medicine methods their impact on the progression of myocardial dysfunction and cardiac arrhythmias.SummaryMore important than parasympathetic impaired sinus node regulation, recent evidence indicates that myocardial sympathetic denervation associated with coronary microvascular derangements is causally related to myocardial injury and arrhythmia in CHD. Additionally,123I-MIBG imaging is a promising tool for risk stratification of progression of ventricular dysfunction and sudden death.
Source: Current Cardiology Reports - Category: Cardiology Source Type: research