Department of Medicine, Clinical Electrophysiology and Pacing, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada.
Department of Experimental Cardiology, Institute of Tropical Medicine, Central University of Venezuela Section of Cardiology, Caracas, Venezuela.
Trends Cardiovasc Med. 2021 May;31(4):233-239. doi: 10.1016/j.tcm.2020.04.004. Epub 2020 May 3.
Chagas' disease and Lyme disease are two endemic, vector-borne zoonotic infectious diseases that impact multiple organ systems, including the heart. Chagas' cardiomyopathy is a progressive process that can evolve into a dilated cardiomyopathy and heart failure several decades after the acute infection; in contrast, although early-disseminated Lyme carditis has been relatively well characterized, the sequelae of Lyme disease on the heart are less well-defined. A century of research on Chagas' cardiomyopathy has generated compelling data for pathophysiological models, evaluated the efficacy of therapy in large randomized controlled trials, and explored the social determinants of health impacting preventative measures. Recognizing the commonalities between Chagas' disease and Lyme disease, we speculate on whether some of the lessons learned from Chagas' cardiomyopathy may be applicable to Lyme carditis.
查加斯病和莱姆病是两种地方性、媒介传播的人畜共患传染病,影响多个器官系统,包括心脏。查加斯心肌病是一种进行性疾病,在急性感染后几十年可发展为扩张型心肌病和心力衰竭;相比之下,尽管早期播散性莱姆心炎已得到较为充分的描述,但莱姆病对心脏的后遗症尚不清楚。一个世纪以来对查加斯心肌病的研究为病理生理学模型提供了有力的数据,在大型随机对照试验中评估了治疗的疗效,并探讨了影响预防措施的健康社会决定因素。鉴于查加斯病和莱姆病之间的共同性,我们推测从查加斯心肌病中获得的一些经验教训是否可能适用于莱姆心炎。