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Published on: November 5, 2021
Cardiac involvement in Chagas disease and African trypanosomiasis
Ester Cerdeira Sabino1, Maria Carmo P Nunes2, Johannes Blum3,4
1Department of Pathology, Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil. sabinoec@usp.br.
Insights
Chagas disease, caused by Trypanosoma cruzi, is a significant cause of heart disease. Global migration has spread this parasitic infection, necessitating broader awareness among cardiologists worldwide.
Area of Science:
- Infectious Diseases
- Cardiology
- Parasitology
Background:
- Trypanosomiases are protozoan parasitic diseases with varied clinical outcomes.
- Trypanosoma cruzi causes Chagas disease, primarily affecting the heart and digestive system.
- Trypanosoma brucei causes African trypanosomiasis, impacting the central nervous system.
Purpose of the Study:
- To review the cardiac effects of trypanosomiases, focusing on Chagas disease.
- To highlight Chagas cardiomyopathy as a major cause of heart disease in Latin America.
- To inform cardiologists globally about the expanding prevalence of Chagas disease.
Main Methods:
- Review of existing literature on trypanosomiases and cardiac manifestations.
- Analysis of epidemiological data concerning Chagas disease.
- Discussion of the global dissemination of Trypanosoma cruzi infections.
Main Results:
- Chagas disease remains a leading cause of cardiomyopathy in endemic Latin American regions.
- International migration has led to a significant increase in Chagas disease cases outside traditional areas.
- Trypanosoma cruzi infections are now found globally, including Europe and the USA.
Conclusions:
- Cardiologists worldwide must recognize and manage Chagas cardiomyopathy.
- The global spread of Chagas disease requires increased clinical vigilance and awareness.
- Understanding the expanded epidemiology of Chagas disease is crucial for patient care.
Abstract:
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.
