Case 4/2019 - 26-Year-Old Man with Congenital Chagas Disease and Heart Transplantation

Abstract Dilated cardiomyopathy (DCM) is a clinical syndrome characterized by left ventricular dilatation and contractile dysfunction. It is the most common cause of heart failure in young adults. The advent of next-generation sequencing has contributed to the discovery of a large amount of genomic data related to DCM. Mutations involving genes that encode cytoskeletal proteins, the sarcomere, and ion channels account for approximately 40% of cases previously classified as idiopathic DCM. In this scenario, geneticists and cardiovascular genetics specialists have begun to work together, building knowledge and establishing more accurate diagnoses. However, proper interpretation of genetic results is essential and multidisciplinary teams dedicated to the management and analysis of the obtained information should be considered. In this review, we approach genetic factors associated with DCM and their prognostic relevance and discuss how the use of genetic testing, when well recommended, can help cardiologists in the decision-making process.Resumo A miocardiopatia dilatada (MCD) é uma síndrome caracterizada por dilatação ventricular esquerda e disfunção contrátil, sendo considerada a causa mais comum de insuficiência cardíaca em adultos jovens. O uso do sequenciamento de nova geração tem contribuído com a descoberta de uma grande quantidade de dados genômicos r elacionados à MCD, identi...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research

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Authors: De Vecchis R, Paccone A, Di Maio M Abstract BACKGROUND: Clinical efficacy of sacubitril/ valsartan - administered for the recommended indication of patients with reduced(
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Abstract Follicular unit excision (FUE) requires the careful excision of hair-bearing follicular units. The follicle can only be detached from the skin once the epidermis, dermis, and subcutaneous tissues are cut, and each layer requires a different amount of force. Traditional FUE devices can be set only to a single speed during a single excision. The Trivellini Device is a first-in-class programmable multiphasic device that is able to accommodate the cutting of various layers of tissue in a single program, while ensuring minimal transection of hair grafts. We detail the advances in the field of motorized FUE emb...
Source: Skinmed - Category: Dermatology Authors: Tags: Skinmed Source Type: research
Conclusions: The models developed using insurance claims data could reliably predict the risk of MACRO in patients with T2DM and enabled patients at higher-risk of DKD to be identified in the absence of baseline diabetic nephropathy, CKD, or proteinuria. These models could help establish strategies to reduce the risk of MACRO in T2DM patients. PMID: 31625766 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Conclusions: We suggest some distinct molecular mechanisms for production of IL-1β in innate immune cells from patients with different clinical forms of Chagas disease. MMP-2 and MMP-9 gelatinases are associated with distinct disease outcomes and IL-1β production. Introduction Chagas disease, also known as American trypanosomiasis, is a neglected parasitic disease caused by the protozoan Trypanosoma cruzi (1), that affects millions of people in the world (2). During the acute phase, a diffuse and intense inflammation in the cardiomyocytes is observed, which is composed mainly of neutrophils, monocytes, and ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions/SignificanceThe different clinical stages of chronic Chagas disease display distinct monocyte profiles that are restored after anti-parasite drug therapy.T.cruzi-infected subjects with severe cardiac disease displayed a profile of monocytes subsets suggestive of a more pronounced inflammatory environment compared with subjects suffering from heart failure not related toT.cruzi infection, supporting that parasite persistence might also alter cell components of the innate immune system.
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research
Chagas disease (CD) is a frequent cause of dilated cardiomyopathy (CMP) in developing countries, leading to clinical heart failure and worse prognosis. Therefore, the development and evolution of this CMP has ...
Source: Cardiovascular Ultrasound - Category: Radiology Authors: Source Type: research
Conclusions: To the best of our knowledge, this is the first study to investigate MIG in patients with CD and DCM. The significant increase of MIG in patients with CD and advanced heart failure, the negative correlation between MIG and left ventricular ejection fraction, and the clear trend in discrimination using a cutoff value found in patients with DCM require further investigation to clarify the diagnostic and prognostic potential of MIG in these patients.
Source: Journal of Cardiovascular Pharmacology - Category: Cardiology Tags: Original Article Source Type: research
Conclusion: we observed that AI correlated with CCHD stages and contributed, in association with anti-B13 antibodies and age, to the prediction of systolic heart failure.RESUMO Introducción: la miocardiopatía chagásica (MCC) es la manifestación más común de la tripanosomiasis americana, causando cerca de 50.000 muertes al año. Varios factores se asocian con la gravedad de MCC. Sin embargo, la evaluación de la contribución de los principales factores de riesgo cardiovascular (FRC), como la hipertensión y la dislipidemia aterogénica (DA), a la grave...
Source: Revista da Associacao Medica Brasileira - Category: Journals (General) Source Type: research
Chagas disease is caused by a protozoan named Trypanosoma cruzi transmitted to humans by reduviid bugs. Severe dilated cardiomyopathy from chronic T cruzi infection is the most common finding, leading to end-stage heart failure. Heart transplant is an effective treatment for Chagas heart disease. However, T cruzi reactivation is of great concern, predisposing patients to episodes of myocarditis and rejection. A 56-year-old woman with a history of Chagas disease and elevated calculated panel reactive antibodies (CPRAs) underwent induction therapy and desensitization strategies aimed at lowering CPRAs, as elevated CPRAs have...
Source: Progress in Transplantation - Category: Transplant Surgery Authors: Tags: Clinical Issues in Transplantation Source Type: research
THE BIOLOGY OF THE TRIATOMINE BUGS NATIVE TO SOUTH CENTRAL TEXAS AND ASSESSMENT OF THE RISK THEY POSE FOR AUTOCHTHONOUS CHAGAS DISEASE EXPOSURE. J Parasitol. 2015 Jul 13; Authors: Wozniak EJ, Lawrence G, Gorchakov R, Murray KO, Alamgir AH, Dotson E, Sissel B, Sarkar S Abstract Triatomine bugs are a group of hematophagous arthropods that can serve as biological vectors for Trypanosoma cruzi, the etiological agent of American trypanosomiasis (Chagas disease). Because of differences in the biology and feeding habits among triatomine species, some are more likely than others to be involved in zoonotic and...
Source: The Journal of Parasitology - Category: Parasitology Authors: Tags: J Parasitol Source Type: research
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