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恰加斯病性心肌病中的心律失常

Arrhythmias in chagasic cardiomyopathy.

作者信息

Healy Chris, Viles-Gonzalez Juan F, Sáenz Luis C, Soto Mariana, Ramírez Juan D, d'Avila Andre

机构信息

Department of Cardiac Electrophysiology, University of Miami Miller School of Medicine, 1295 NW 14th Street, South Building, Suite A, Miami, FL 33125, USA.

Cardiólogo-Electrofisiólogo, Fundación Cardio Infantil-Instituto de Cardiología, Calle 163A No 13B-60, Bogotá, Colombia.

出版信息

Card Electrophysiol Clin. 2015 Jun;7(2):251-68. doi: 10.1016/j.ccep.2015.03.016.

Abstract

Chagas disease, a chronic parasitosis caused by the protozoa Trypanosoma cruzi, is an increasing worldwide problem because of the number of cases in endemic areas and the migration of infected individuals to more developed regions. Chagas disease affects the heart through cardiac parasympathetic neuronal depopulation, immune-mediated myocardial injury, parasite persistence in cardiac tissue with secondary antigenic stimulation, and coronary microvascular abnormalities causing myocardial ischemia. A lack of knowledge exists for risk stratification, management, and prevention of ventricular arrhythmias in patients with chagasic cardiomyopathy. Catheter ablation can be effective for the management of recurrent ventricular tachycardia.

摘要

恰加斯病是由原生动物克氏锥虫引起的一种慢性寄生虫病,由于流行地区的病例数量以及受感染个体向更发达地区的迁移,它已成为一个日益严重的全球性问题。恰加斯病通过心脏副交感神经节细胞减少、免疫介导的心肌损伤、寄生虫在心脏组织中的持续存在及继发抗原刺激,以及导致心肌缺血的冠状动脉微血管异常来影响心脏。对于恰加斯病性心肌病患者室性心律失常的风险分层、管理和预防,目前仍缺乏认识。导管消融术可有效治疗复发性室性心动过速。

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