Chagas Cardiomyopathy and Myocardial Sympathetic Denervation

Purpose of Review More than a century since its discovery, the pathogenesis of Chagas heart disease (CHD) remains incompletely understood. The role of derangements in the autonomic control of the heart in triggering malignant arrhythmia before the appearance of contractile ventricular impairment was...

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Published in:Current cardiology reports 2024-06, Vol.26 (6), p.635-641
Main Authors: Gadioli, Leonardo Pippa, Schmidt, André, Maciel, Benedito Carlos, Volpe, Gustavo Jardim, Simões, Marcus Vinicius, Marin-Neto, José Antonio
Format: Article
Language:English
Subjects:
3-Iodobenzylguanidine
Arrhythmias, Cardiac - etiology
Arrhythmias, Cardiac - physiopathology
Cardiology
Chagas Cardiomyopathy - complications
Chagas Cardiomyopathy - physiopathology
Chagas Cardiomyopathy - surgery
Heart - diagnostic imaging
Heart - innervation
Humans
Medicine
Medicine & Public Health
Nuclear Cardiology (V Dilsizian
Section Editor
Sympathectomy - methods
Sympathetic Nervous System - physiopathology
Topical Collection on Nuclear Cardiology
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Summary:Purpose of Review More than a century since its discovery, the pathogenesis of Chagas heart disease (CHD) remains incompletely understood. The role of derangements in the autonomic control of the heart in triggering malignant arrhythmia before the appearance of contractile ventricular impairment was reviewed. Recent Findings Although previous investigations had demonstrated the anatomical and functional consequences of parasympathetic dysautonomia upon the heart rate control, only recently, coronary microvascular disturbances and sympathetic denervation at the ventricular level have been reported in patients and experimental models of CHD, exploring with nuclear medicine methods their impact on the progression of myocardial dysfunction and cardiac arrhythmias. Summary More important than parasympathetic impaired sinus node regulation, recent evidence indicates that myocardial sympathetic denervation associated with coronary microvascular derangements is causally related to myocardial injury and arrhythmia in CHD. Additionally, 123 I-MIBG imaging is a promising tool for risk stratification of progression of ventricular dysfunction and sudden death.
ISSN:1523-3782
1534-3170
1534-3170
DOI:10.1007/s11886-024-02057-y