Developments in the management of Chagas cardiomyopathy

Herbert B. Tanowitz, Fabiana S. Machado, David C. Spray, Joel M. Friedman, Oren S. Weiss, Jose N. Lora, Jyothi Nagajyothi, Diego N. Moraes, Nisha Garg, Maria Carmo P Nunes, Antonio Luiz P Ribeiro

Research output: Contribution to journalArticle

27 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1393-1409
Number of pages17
JournalExpert Review of Cardiovascular Therapy
Volume13
Issue number12
DOIs
StatePublished - Dec 2 2015

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Keywords

  • Arrhythmias
  • Chagas cardiomyopathy
  • Chagas disease
  • Heart failure
  • Myocardial fibrosis
  • Nanotechnology
  • Oxidative stress
  • Stem cell therapy
  • Vaccine development

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Tanowitz, H. B., Machado, F. S., Spray, D. C., Friedman, J. M., Weiss, O. S., Lora, J. N., Nagajyothi, J., Moraes, D. N., Garg, N., Nunes, M. C. P., & Ribeiro, A. L. P. (2015). Developments in the management of Chagas cardiomyopathy. Expert Review of Cardiovascular Therapy, 13(12), 1393-1409. https://doi.org/10.1586/14779072.2015.1103648