Key result
Chagas' disease is now understood as a congestive cardiomyopathy of parasitic origin rather than a primary cardioneuromyopathy, with autonomic abnormalities being secondary.
This review highlights the paradigm shift in understanding Chagas' heart disease as a parasitic congestive cardiomyopathy rather than a primary autonomic neuropathy.
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May prompt parasitic-focused management in Chagas cardiomyopathy; leaves open need for prospective trials before practice change.
Primary abnormalities of the autonomic nervous system had been postulated as the pathogenic mechanisms of myocardial damage, in patients with Chagas disease. However, recent investigations indicate that these abnormalities are secondary and amenable to treatment with beta-adrenergic blockers. Moreover, muscarinic cardiac autoantibodies appear to enhance parasympathetic activity on the sinus node. Therefore, the purpose of this paper is to analyze how knowledge on Chagas' disease evolved from being initially considered as a primary cardioneuromyopathy to the current status of a congestive cardiomyopathy of parasitic origin.
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Dávila et al. (2012) conducted a review in Chagas' Heart Disease. Chagas' disease is now understood as a congestive cardiomyopathy of parasitic origin rather than a primary cardioneuromyopathy, with autonomic abnormalities being secondary.
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