Chagas disease is associated with a poor outcome at 1-year follow-up after cardiac resynchronization therapy

CONCLUSION: In a population of HF patients undergoing CRT, CD was independently associated with mortality and hospitalization for HF.RESUMO INTRODU ÇÃO: A terapia de ressincronização cardíaca (TRC) é uma modalidade terapêutica para pacientes com insuficiência cardíaca (IC). A eficácia desse tratamento para redução de eventos baseia-se em ensaios clínicos em que a população de pacientes com doença de Chagas (DC) é sub-representa da. OBJETIVO: Avaliar o prognóstico após TRC em uma população em que a DC é uma causa frequente de IC. MÉTODOS: Coorte retrospectiva realizada entre janeiro de 2015 e dezembro de 2016, sendo incluídos pacientes portadores de IC com fração de ejeção do ventrículo esquerdo (Feve) menor q ue 35% e submetidos à TRC. Os dados clínicos e demográficos foram coletados para pesquisa de preditores para o desfecho combinado de morte ou internação por IC após implante da TRC. RESULTADOS: Foram avaliados 54 pacientes, dos quais 13 (24,1%) apresentavam a DC como etiologia da IC. A Feve m édia foi de 26,2% (±6,1) e 36 (66,7%) pacientes apresentavam classe funcional de IC III ou IV. Após o seguimento médio de 15 meses, 17 (32,1%) pacientes apresentaram o desfecho combinado. Na análise univariada...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research

Related Links:

Chagas disease was initially described as an endemic health problem in a few countries in South America – mainly Argentina and Brazil – and one of the consequences of the disease, heart damage, made it an interesting issue for healthcare professionals, from epidemiologists to cardiologists.1 Chagas cardiomyopathy (ChCM) is now recognised as a cardiovascular disorder, diagnosed and treated not only in the original region, but also in Europe, North America and even in Asia (Figure 1).
Source: Radcliffe Cardiology - Category: Cardiology Authors: Source Type: research
This study was performed in accordance with the ethical standards of the Institutional Animal Care and Use Committee (IACUC, approval FUA-007-14) from the Unidad de Biología Comparativa (UBA) at Pontificia Universidad Javeriana (PUJ, Bogotá, Colombia). All animal studies were conducted in accordance with the “Guide for the Care and Use of Laboratory Animals” from UBA-PUJ. The present study was described according to the Animal Research: Reporting in vivo Experiments (ARRIVE) criteria from the National Center for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs) (32). Mice ...
Source: Frontiers in Immunology - Category: Allergy & Immunology 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
American trypanosomiasis is caused by a parasite endemic of the Americas. Current migration has globalized Chagas disease. Acute infection usually resolves spontaneously. Nonetheless, 20% to 40% develop cardiomyopathy 20 to 30  years later. Progression to cardiomyopathy is devastatingly rapid, manifesting with heart failure and sudden death. Etiologic treatment is highly effective and recommended in those with acute infections, congenital infections, and parasite reactivation, and women of childbearing age, but in asympt omatic Trypanosoma cruzi carriers and patients with early cardiomyopathy remains controversial and...
Source: Infectious Diseases Clinics of North America - Category: Infectious Diseases Authors: Source Type: research
AbstractPurpose of ReviewChagas disease (CD) is endemic to much of Latin America, but also present in the United States (U.S.). Following a lengthy asymptomatic period, CD produces serious cardiac or gastrointestinal complications in 30 –40% of people. Less than 1% of the estimated six million cases in the Americas, including 326,000–347,000 in the U.S., are diagnosed. Infected persons are typically unaware and the bulk of clinicians are unfamiliar with current treatment guidelines. This review provides U.S. and other clinician s with the latest knowledge of CD treatment.Recent FindingsChagas cardiomyopathy (CC...
Source: Current Treatment Options in Infectious Diseases - Category: Infectious Diseases Source Type: research
ConclusionsResearch on Chagas cardiomyopathy increased over the study period. There were more clinical than basic studies, though very few of the documents were clinical trials. Brazil and the USA are currently leading the research on this subject, while some highly endemic countries, such as Bolivia, have contributed very little. Different approaches could help to redress this imbalance: encouraging researchers to conduct more clinical trials, launching international collaborations to help endemic countries contribute more, and strengthening links between basic and clinical research.
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research
ConclusionsThe distance walked during the 6MWT correlates with BNP, quality of life and parameters of left ventricular diastolic function in ChD patients with heart failure. We propose this test to be adopted in endemic areas with limited resources to aid in the identification of patients who need referral for tertiary centres for further evaluation and treatment.
Source: Tropical Medicine and International Health - Category: Tropical Medicine Authors: Tags: Original Article Source Type: research
ConclusionsThe distance walked during the 6MWT correlates with BNP, quality of life and parameters of left ventricular diastolic function in ChD patients with heart failure. We propose this test to be adopted in endemic areas with limited resources to aid in the identification of patients who need referral for tertiary centers for further evaluation and treatment.This article is protected by copyright. All rights reserved.
Source: Tropical Medicine and International Health - Category: Tropical Medicine Authors: Tags: Original Article Source Type: research
Chagas Disease (CD) is endemic in some regions of the Americas, which according to WHO data, there are 6 to 7 million people infected with Trypanosoma cruzi. Heart transplantation (HTX) is a therapeutic option in terminal heart failure cases associated with this disease. CD is characterized by an acute parasitemic fase, usually symptomatic (fever, hepatosplenomegaly, “chagoma”, myocarditis) followed by a stage of slow evolution, asymptomatic, maintaining positive serology. Some of these patients progress to Chagas cardiomyopathy.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
AbstractChagas disease affects millions of people worldwide. Though the majority of infected individuals remain asymptomatic, approximately 30  % of patients progress to develop cardiac manifestations and eventual heart failure. While vectorial transmission occurs predominantly in South America, Central America, and Mexico, millions of people originally from these endemic regions immigrate to non-endemic countries in North America, Europe , and Asia. Outside of rare specialized centers, health-care providers lack experience diagnosing and treating this disease. This lack of experience likely leads to far fewer Chagas ...
Source: Current Heart Failure Reports - Category: Cardiology Source Type: research
More News: Cardiac Resynchronization Therapy | Cardiology | Chagas Disease | Clinical Trials | Endemics | General Medicine | Heart | Heart Failure | Men