scholarly journals Molecular Remodeling of Cardiac Sinus Node Associated with Acute Chagas Disease Myocarditis

2021 ◽  
Vol 9 (11) ◽  
pp. 2208
Author(s):  
Héctor O. Rodríguez-Angulo ◽  
Diana Colombet-Naranjo ◽  
María C. Maza ◽  
Cristina Poveda ◽  
Alfonso Herreros-Cabello ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Latin American ◽  
Sinus Node ◽  
P Wave ◽  
Continuous Treatment ◽  
American People ◽  
Qtc Interval ◽  
Supraventricular Arrhythmias ◽  
Worldwide Distribution ◽  
Acute Chagas Disease

Chagas disease principally affects Latin-American people, but it currently has worldwide distribution due to migration. Death among those with Chagas disease can occur suddenly and without warning, even in those who may not have evidence of clinical or structural cardiac disease and who are younger than 60 years old. HCN4 channels, one of the principal elements responsible for pacemaker currents, are associated with cardiac fetal reprogramming and supraventricular and ventricular arrhythmias, but their role in chagasic arrhythmias is not clear. We found that a single-dose administration of ivabradine, which blocks HCN4, caused QTc and QRS enlargement and an increase in P-wave amplitude and was associated with ventricular and supraventricular arrhythmias in mice challenged with isoproterenol, a chronotropic/ionotropic positive agent. Continuous treatment with ivabradine did not alter the QTc interval, but P-wave morphology was deeply modified, generating supraventricular arrhythmias. In addition, we found that repolarization parameters improved with ivabradine treatment. These effects could have been caused by the high HCN4 expression observed in auricular and ventricular tissue in infected mice. Thus, we suggest, for the first time, that molecular remodeling by overexpression of HCN4 channels may be related to supraventricular arrhythmias in acute Chagas disease, causing ivabradine over-response. Thus, ivabradine treatment should be administered with caution, while HCN4 overexpression may be an indicator of heart failure and/or sudden death risk.

scholarly journals Chagas disease in Italy: breaking an epidemiological silence

2011 ◽  
Vol 16 (37) ◽  
Author(s):  
A Angheben ◽  
M Anselmi ◽  
F Gobbi ◽  
S Marocco ◽  
G Monteiro ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Latin American ◽  
Wide Spectrum ◽  
Epidemiological Data ◽  
Tropical Diseases ◽  
Positive Serology ◽  
Population Movements ◽  
Health Measures ◽  
University Of Florence ◽  
Acute Chagas Disease

Chagas disease, a neglected tropical disease that due to population movements is no longer limited to Latin America, threatens a wide spectrum of people (travellers, migrants, blood or organ recipients, newborns, adoptees) also in non-endemic countries where it is generally underdiagnosed. In Italy, the available epidemiological data about Chagas disease have been very limited up to now, although the country is second in Europe only to Spain in the number of residents from Latin American. Among 867 at-risk subjects screened between 1998 and 2010, the Centre for Tropical Diseases in Negrar (Verona) and the Infectious and Tropical Diseases Unit, University of Florence found 4.2% patients with positive serology for Chagas disease (83.4% of them migrants, 13.8% adoptees). No cases of Chagas disease were identified in blood donors or HIV-positive patients of Latin American origin. Among 214 Latin American pregnant women, three were infected (resulting in abortion in one case). In 2005 a case of acute Chagas disease was recorded in an Italian traveller. Based on our observations, we believe that a wider assessment of the epidemiological situation is urgently required in our country and public health measures preventing transmission and improving access to diagnosis and treatment should be implemented.

Major Kinds of Drug Targets in Chagas Disease or American Trypanosomiasis

2019 ◽  
Vol 20 (11) ◽  
pp. 1203-1216 ◽  
Author(s):  
Vilma G. Duschak
Keyword(s):  
Chagas Disease ◽  
Latin American ◽  
Drug Targets ◽  
Defense Mechanisms ◽  
Cysteine Proteinase ◽  
Parasitic Infection ◽  
Etiologic Agent ◽  
World Health ◽  
American Trypanosomiasis ◽  
Group I

American Trypanosomiasis, a parasitic infection commonly named Chagas disease, affects millions of people all over Latin American countries. Presently, the World Health Organization (WHO) predicts that the number of international infected individuals extends to 7 to 8 million, assuming that more than 10,000 deaths occur annually. The transmission of the etiologic agent, Trypanosoma cruzi, through people migrating to non-endemic world nations makes it an emergent disease. The best promising targets for trypanocidal drugs may be classified into three main groups: Group I includes the main molecular targets that are considered among specific enzymes involved in the essential processes for parasite survival, principally Cruzipain, the major antigenic parasite cysteine proteinase. Group II involves biological pathways and their key specific enzymes, such as Sterol biosynthesis pathway, among others, specific antioxidant defense mechanisms, and bioenergetics ones. Group III includes the atypical organelles /structures present in the parasite relevant clinical forms, which are absent or considerably different from those present in mammals and biological processes related to them. These can be considered potential targets to develop drugs with extra effectiveness and fewer secondary effects than the currently used therapeutics. An improved distinction between the host and the parasite targets will help fight against this neglected disease.

scholarly journals Current knowledge of Chagas-related heart disease among pediatric cardiologists in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanchi Malhotra ◽  
Imran Masood ◽  
Noberto Giglio ◽  
Jay D. Pruetz ◽  
Pia S. Pannaraj
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Chagas Disease ◽  
Latin American ◽  
Current Knowledge ◽  
Parasitic Infection ◽  
The United States ◽  
Cardiac Complications ◽  
The U.S

Abstract Background Chagas disease is a pathogenic parasitic infection with approximately 8 million cases worldwide and greater than 300,000 cases in the United States (U.S.). Chagas disease can lead to chronic cardiomyopathy and cardiac complications, with variable cardiac presentations in pediatrics making it difficult to recognize. The purpose of our study is to better understand current knowledge and experience with Chagas related heart disease among pediatric cardiologists in the U.S. Methods We prospectively disseminated a 19-question survey to pediatric cardiologists via 3 pediatric cardiology listservs. The survey included questions about demographics, Chagas disease presentation and experience. Results Of 139 responses, 119 cardiologists treat pediatric patients in the U.S. and were included. Most providers (87%) had not seen a case of Chagas disease in their practice; however, 72% also had never tested for it. The majority of knowledge-based questions about Chagas disease cardiac presentations were answered incorrectly, and 85% of providers expressed discomfort with recognizing cardiac presentations in children. Most respondents selected that they would not include Chagas disease on their differential diagnosis for presentations such as conduction anomalies, myocarditis and/or apical aneurysms, but would be more likely to include it if found in a Latin American immigrant. Of respondents, 87% agreed that they would be likely to attend a Chagas disease-related lecture. Conclusions Pediatric cardiologists in the U.S. have seen very few cases of Chagas disease, albeit most have not sent testing or included it in their differential diagnosis. Most individuals agreed that education on Chagas disease would be worth-while.

Investigation of two outbreaks of suspected oral transmission of acute Chagas disease in the Amazon region, Pará State, Brazil, in 2007

2009 ◽  
Vol 39 (4) ◽  
pp. 231-232 ◽  
Author(s):  
Henrique de Barros Moreira Beltrão ◽  
Matheus de Paula Cerroni ◽  
Daniel Roberto Coradi de Freitas ◽  
Ana Yecê das Neves Pinto ◽  
Vera da Costa Valente ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Amazon Region ◽  
Oral Transmission ◽  
Acute Chagas Disease

Acute Chagas Disease in the Brazilian Amazon: Epidemiological and clinical features

2017 ◽  
Vol 235 ◽  
pp. 176-178 ◽  
Author(s):  
Elenild de Góes Costa ◽  
Soraya Oliveira dos Santos ◽  
Mayira Sojo-Milano ◽  
Ednei C.C. Amador ◽  
Erica Tatto ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Clinical Features ◽  
Brazilian Amazon ◽  
Acute Chagas Disease

The use of Levosimendan for myocardiopathy due to acute Chagas' disease

2009 ◽  
Vol 136 (2) ◽  
pp. 233-235 ◽  
Author(s):  
Rafael de March Ronsoni ◽  
Rubens Vaz Feijó ◽  
Luiz Henrique Melo ◽  
Fabiano Luis Schwingel ◽  
Wilson Jacob Filho ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Acute Chagas Disease

Widespread distribution and rate differentiation of the atrial pacemaker complex

1980 ◽  
Vol 239 (3) ◽  
pp. H406-H415 ◽  
Author(s):  
J. P. Boineau ◽  
R. B. Schuessler ◽  
D. B. Hackel ◽  
C. B. Miller ◽  
C. W. Brockus ◽  
...  
Keyword(s):  
Superior Vena ◽  
Sinus Node ◽  
P Wave ◽  
Right Atrial ◽  
Superior Vena Caval ◽  
Heart Rates ◽  
Widespread Distribution ◽  
Depolarization Wave ◽  
Lower Limits ◽  
Origin Point

In a study to examine the basis of rate-related changes in the electrocardiographic P wave we found a multicentric rather than unifocal origin of the atrial depolarization wave in dogs. Three to five pacemakers, or origin points, were distributed over a 30- to 40-mm area compared to the 11-mm size of the sinus node. Two or three of the sites could excite simultaneously, or one specific site would dominate excitation. Each separate origin point dominated excitation within a specific range of heart rates, and on reaching either the upper or lower limits of this range, a new focus abruptly dominated and initiated the atrial wave front. We have obtained evidence to suggest that these findings may be explained by a widely distributed atrial pacemaker complex. The spatial distribution of this system exceeded the dimensions of the canine sinus node by a factor of three to four times. The pacemaker centers, although distributed, were consistently located at specific positions along the superior vena caval-right atrial junction. Also, each separate pacemaker site appeared functionally differentiated to generate a specific range of heart rates. We propose that in addition to the sinus node there are other specialized atrial pacemaker centers, and that this specialization, including the differentiated response and coordination, is conferred by focal receptor characteristics and their inputs.

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