Messejana Heart and Lung Hospital Dr. Carlos Alberto Studart Gomes, Av. Frei Cirilo, 3480 Messejana, Fortaleza, CE, 60.846-190, Brazil.
Curr Cardiol Rep. 2019 Feb 12;21(2):8. doi: 10.1007/s11886-019-1095-y.
Chagas cardiomyopathy is a major public health disease in Latin America and, due to migration, is becoming a worldwide health and economic burden. This review sought to present the clinical and epidemiological aspects of Chagas cardiomyopathy, as well as some specific features and principles of treatment. We also retrospectively assessed our institutional experience with mechanical circulatory support in refractory heart failure due to Chagas cardiomyopathy over a 10-year period.
The role of antiparasitic treatment in patients with heart failure due to Chagas cardiomyopathy is controversial. Heart transplantation, although formerly contraindicated, is currently established as an important therapeutic option. Also, the favorable characteristics of Chagas patients, such as younger age, little comorbidity, and no reoperations or severe pulmonary hypertension, could be an advantage for a mechanical circulatory support indication in advanced heart failure due to Chagas cardiomyopathy. Despite the absence of large evidence-based data, much has been accomplished since Carlos Chagas' discovery one century ago. Our institutional experience shows that mechanical circulatory support in Chagas patients is associated with more successful bridging to heart transplantation when compared to non-Chagas patients.
恰加斯心肌病是拉丁美洲的一种主要公共卫生疾病，由于移民，它正在成为全球范围内的健康和经济负担。本综述旨在介绍恰加斯心肌病的临床和流行病学特征，以及一些特定的治疗原则和特征。我们还回顾性评估了我们机构在过去 10 年中使用机械循环支持治疗因恰加斯心肌病导致的难治性心力衰竭的经验。
针对恰加斯心肌病心力衰竭患者使用抗寄生虫治疗的作用存在争议。心脏移植虽然以前被认为是禁忌的，但目前已被确立为一种重要的治疗选择。此外，恰加斯患者的有利特征，如年龄较小、合并症较少、无再次手术或严重肺动脉高压等，可能是晚期因恰加斯心肌病导致心力衰竭患者使用机械循环支持的指征的优势。尽管缺乏基于大型证据的数据，但自一个世纪前卡洛斯·恰加斯发现以来，已经取得了很大的进展。我们机构的经验表明，与非恰加斯患者相比，机械循环支持在恰加斯患者中更有助于成功桥接心脏移植。
