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Chagas cardiomyopathy in the context of the chronic disease transition

Alicia I Hidron1, Robert H Gilman, Juan Justiniano

  • 1Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America.

Plos Neglected Tropical Diseases
|May 27, 2010
PubMed

Insights

Chagas cardiomyopathy is a significant cause of heart failure in urban Bolivia, exacerbated by common cardiac risk factors like hypertension and obesity. Early detection and management are crucial for improving patient outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Chagas disease patients are increasingly migrating to urban areas.
  • Urban environments present common cardiac risk factors such as obesity and hypertension.

Purpose of the Study:

  • To investigate the prevalence and impact of Trypanosoma cruzi infection in an urban Bolivian population.
  • To assess the association between T. cruzi infection, cardiac risk factors, and Chagas cardiomyopathy.

Main Methods:

  • Cross-sectional study of 394 adult patients at a public hospital in Santa Cruz, Bolivia.
  • Utilized serology and PCR (conventional and real-time) for T. cruzi detection.
  • Collected data on risk factors, medical history, physical examination, echocardiogram, and mortality.

Main Results:

  • 64% of participants had confirmed T. cruzi infection; 43% were positive by conventional PCR.
  • High prevalence of hypertension (64%) and overweight (67%) observed, independent of T. cruzi status.
  • Chagas cardiomyopathy accounted for nearly 60% of heart failure cases; mortality was higher in seropositive individuals.

Conclusions:

  • Chagas cardiomyopathy is a major cause of heart failure in this urban population.
  • The epidemiological transition, with increased cardiovascular risk factors, complicates Chagas disease management.
  • Evaluating Chagas cardiomyopathy requires considering both infection and co-existing risk factors like obesity and hypertension.
Abstract

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