Chagasic cardiomyopathy, from acute to chronic: is this mediated by host susceptibility factors?

Chronic chagasic cardiomyopathy (CCC) is the main contributor to morbidity and mortality among individuals chronically infected with the protozoan parasite Trypanosoma cruzi. However, cardiomyopathy develops in fewer than one-third of these patients. Among the different mechanisms to explain this variability are environmental factors, T. cruzi genetic diversity, and host susceptibility. CCC is the culmination of a pathologic process with an onset during the acute infection phase. Previous studies of host genetic factors have been limited to a few candidate genes. This review describes the pathologic features of acute and chronic myocarditis and the host susceptibility factors that may contribute to the development of chagasic cardiomyopathy.