Department of Pathology, Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Nat Rev Cardiol. 2024 Dec;21(12):865-879. doi: 10.1038/s41569-024-01057-3. Epub 2024 Jul 15.
Trypanosomiases are diseases caused by various species of protozoan parasite in the genus Trypanosoma, each presenting with distinct clinical manifestations and prognoses. Infections can affect multiple organs, with Trypanosoma cruzi predominantly affecting the heart and digestive system, leading to American trypanosomiasis or Chagas disease, and Trypanosoma brucei primarily causing a disease of the central nervous system known as human African trypanosomiasis or sleeping sickness. In this Review, we discuss the effects of these infections on the heart, with particular emphasis on Chagas disease, which continues to be a leading cause of cardiomyopathy in Latin America. The epidemiology of Chagas disease has changed substantially since 1990 owing to the emigration of over 30 million Latin American citizens, primarily to Europe and the USA. This movement of people has led to the global dissemination of individuals infected with T. cruzi. Therefore, cardiologists worldwide must familiarize themselves with Chagas disease and the severe, chronic manifestation - Chagas cardiomyopathy - because of the expanded prevalence of this disease beyond traditional endemic regions.
锥虫病是由锥虫属的各种原生动物寄生虫引起的疾病，每种寄生虫都有不同的临床表现和预后。感染可影响多个器官，克氏锥虫主要影响心脏和消化系统，导致美洲锥虫病或恰加斯病，布氏锥虫主要引起一种中枢神经系统疾病，称为人类非洲锥虫病或昏睡病。在这篇综述中，我们讨论了这些感染对心脏的影响，特别强调了恰加斯病，它仍然是拉丁美洲心肌病的主要原因。自 1990 年以来，由于超过 3000 万拉丁美洲公民移民，主要是到欧洲和美国，恰加斯病的流行病学发生了重大变化。这种人口流动导致了感染 T. cruzi 的个体在全球范围内的传播。因此，由于这种疾病的流行范围已经超出了传统的流行地区，全世界的心脏病专家都必须熟悉恰加斯病和严重的慢性表现——恰加斯心肌病。
