Punukollu Gopikrishna, Gowda Ramesh M, Khan Ijaz A, Navarro Victor S, Vasavada Balendu C
Division of Cardiology, Long Island College Hospital, Brooklyn, NY, USA.
Int J Cardiol. 2007 Feb 14;115(3):279-83. doi: 10.1016/j.ijcard.2006.03.004.
Chagas' heart disease, caused by protozoan Trypanosoma cruzi, is a common cause of cardiomyopathy in the Americas. Transmission of T. cruzi occurs through Reduviids, the kissing bugs. Less common ways of transmission are blood transfusion, congenital transmission, organ transplantation, laboratory accident, breastfeeding, and oral contamination. Infestation results in cardiac dysautonomia, myocardial apoptosis, and myocardial fibrosis. In acute phase, death is mostly caused by myocarditis and in chronic phase, it is mostly by irreversible cardiomyopathy. A majority of the patients with Chagas' disease remain in the latent phase of disease for 10 to 30 years or even for life. Specific anti-Chagas' therapy with trypanocide drugs is useful in acute phase but the management of chronic Chagas' heart disease is mostly empirical. The mortality during the acute phase of cardiac Chagas is around 5%. Five-year mortality of chronic Chagas' disease with cardiac dysfunction is above 50%. The clinical aspects of the Chagas' heart disease are concisely reviewed.
恰加斯心脏病由原生动物克氏锥虫引起，是美洲心肌病的常见病因。克氏锥虫通过猎蝽（即接吻虫）传播。较少见的传播途径包括输血、先天性传播、器官移植、实验室事故、母乳喂养和经口感染。感染会导致心脏自主神经功能异常、心肌细胞凋亡和心肌纤维化。急性期，死亡主要由心肌炎引起；慢性期，则主要由不可逆的心肌病导致。大多数恰加斯病患者会在疾病的潜伏期持续10至30年，甚至终生。使用杀锥虫药物进行特异性抗恰加斯病治疗在急性期有效，但慢性恰加斯心脏病的治疗大多基于经验。心脏型恰加斯病急性期的死亡率约为5%。伴有心脏功能障碍的慢性恰加斯病患者的五年死亡率超过50%。本文简要综述了恰加斯心脏病的临床情况。
