Pathogenesis of chronic Chagas' myocarditis

The pathogenesis of chronic Chagas' myocarditis is still not completely understood. Several theories have been advanced: 1)direct tissue destruction by Trypanosoma cruzi; 2) neurogenic theory; 3) anti-heart immune reactions; and 4) microvascular disease. We present herein a dynamic alternative...

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Detalles Bibliográficos
Autor: Rossi, Marcos A.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:1995
País:Brasil
Institución:Associação Paulista de Medicina
Repositorio:São Paulo medical journal (Online)
Idioma:inglés
OAI Identifier:oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/1597
Acceso en línea:https://periodicosapm.emnuvens.com.br/spmj/article/view/1597
Access Level:acceso abierto
Palabra clave:Myocarditis
Chagas's disease
Descripción
Sumario:The pathogenesis of chronic Chagas' myocarditis is still not completely understood. Several theories have been advanced: 1)direct tissue destruction by Trypanosoma cruzi; 2) neurogenic theory; 3) anti-heart immune reactions; and 4) microvascular disease. We present herein a dynamic alternative hypothesis. We believe that the development of myocarditis is related to progressive and additive focal cellular necrosis, and associated reactive and reparative myocardial fibrosis and surrounding myocyte hypertrophy. These processes may be initiated and perpetuated by anti immune factors and alterations in the myocardial microcirculation. The destruction of the ganglion cells of the heart may be involved in the patho-clinical evolution of chronic Chagas' cardiopathy. This could imply future therapeutic strategies in the management of chronic Chagas' patients to enhance medical treatment and, hopefully, improve prognosis.