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Expert Rev Cardiovasc Ther. 2015 Dec;13(12):1393-409. doi: 10.1586/14779072.2015.1103648. Epub 2015 Oct 23.

Developments in the management of Chagas cardiomyopathy.

Author information

1
a Department of Pathology , Albert Einstein College of Medicine , Bronx , NY , USA.
2
b Department of Medicine , Albert Einstein College of Medicine , Bronx , NY , USA.
3
c Department of Biochemistry and Immunology, Institute of Biological Science , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
4
d Program in Health Sciences: Infectious Diseases and Tropical Medicine, Medical School , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
5
e Dominick P. Purpura Department of Neuroscience , Albert Einstein College of Medicine , Bronx , NY , USA.
6
f Department of Physiology & Biophysics , Albert Einstein College of Medicine , Bronx , NY , USA.
7
g Public Health Research Institute, New Jersey Medical School , Rutgers University , Newark , NJ , USA.
8
h Department of Internal Medicine and University Hospital , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
9
i Department of Microbiology & Immunology and Institute for Human Infections and Immunity , University of Texas Medical Branch , Galveston , TX , USA.

Abstract

Over 100 years have elapsed since the discovery of Chagas disease and there is still much to learn regarding pathogenesis and treatment. Although there are antiparasitic drugs available, such as benznidazole and nifurtimox, they are not totally reliable and often toxic. A recently released negative clinical trial with benznidazole in patients with chronic Chagas cardiomyopathy further reinforces the concerns regarding its effectiveness. New drugs and new delivery systems, including those based on nanotechnology, are being sought. Although vaccine development is still in its infancy, the reality of a therapeutic vaccine remains a challenge. New ECG methods may help to recognize patients prone to developing malignant ventricular arrhythmias. The management of heart failure, stroke and arrhythmias also remains a challenge. Although animal experiments have suggested that stem cell based therapy may be therapeutic in the management of heart failure in Chagas cardiomyopathy, clinical trials have not been promising.

KEYWORDS:

Arrhythmias; Chagas cardiomyopathy; Chagas disease; heart failure; myocardial fibrosis; nanotechnology; oxidative stress; stem cell therapy; vaccine development

PMID:
26496376
PMCID:
PMC4810774
DOI:
10.1586/14779072.2015.1103648
[Indexed for MEDLINE]
Free PMC Article

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