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Chagas Cardiomyopathy: Evidence in Medical and Nutritional Management

  • Metabolism in Tropical Health (K Schlosser, Section Editor)
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Abstract

Purpose of Review

Chagas cardiomyopathy (CC) is a prevalent manifestation of Chagas disease, responsible for high mortality. Treatment and management have not changed significantly, and there is still a lack of consensus about the proper approach. Particular characteristics in the pathogenesis and clinical manifestations of CC cause inadequate treatment. This review aims to describe the treatment and management of CC currently indicated and describe topics of discussion and future medical and nutritional interventions.

Recent Findings

New evidence suggests benznidazole (BZ) is beneficial in the treatment of CC. Also, posaconazole as adjuvant treatment could be beneficial. ECA inhibitors, β-blockers, and ivabradine show benefit in CC. Amiodarone as treatment of ventricular arrhythmias but also inhibiting Trypanosoma cruzi infection is described. Nutritional supplementation prevents progression of CC as adjuvant therapy.

Summary

Treatment in CC cardiomyopathy has not changed over the years; use of benznidazole may be beneficial reducing parasitemia although there is no consistent survival improvement. Novel therapies failed to produce promising results in animal models to human models. Nutritional supplementation plays an important role in reducing proinflammatory cytokines and could be in the in the future adjuvant therapy. Investigation in CC is needed to address important topics.

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  1. Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico

    Miguel Alejandro Cutz Ijchajchal, Jorge Estuardo Aceituno Melgar, Jhonatan Josué Hernández Marroquín & José Carlos Penagos Cordón

  2. Guatemala City, Guatemala

    Miguel Alejandro Cutz Ijchajchal

  3. Hospital General San Juan de Dios, Guatemala City, Guatemala

    Maria Luisa Eva Lopez

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  1. Miguel Alejandro Cutz Ijchajchal
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Miguel Alejandro Cutz Ijchajchal, Maria Luisa Eva Lopez, Jorge Estuardo Aceituno Melgar, Jhonatan Josué Hernández Marroquín, and Jose Carlos Penagos Cordón declare no conflict of interest.

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Cutz Ijchajchal, M.A., Eva Lopez, M.L., Aceituno Melgar, J.E. et al. Chagas Cardiomyopathy: Evidence in Medical and Nutritional Management. Curr Trop Med Rep 5, 193–203 (2018). https://doi.org/10.1007/s40475-018-0155-5

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