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Current Cardiology Reports

24-04-2024 | Neurotomy | Nuclear Cardiology (V Dilsizian, Section Editor)

Chagas Cardiomyopathy and Myocardial Sympathetic Denervation

Authors: Leonardo Pippa Gadioli, André Schmidt, Benedito Carlos Maciel, Gustavo Jardim Volpe, Marcus Vinicius Simões, José Antonio Marin-Neto

Published in: Current Cardiology Reports

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Abstract

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, 123I-MIBG imaging is a promising tool for risk stratification of progression of ventricular dysfunction and sudden death.
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Metadata
Title
Chagas Cardiomyopathy and Myocardial Sympathetic Denervation
Authors
Leonardo Pippa Gadioli
André Schmidt
Benedito Carlos Maciel
Gustavo Jardim Volpe
Marcus Vinicius Simões
José Antonio Marin-Neto
Publication date
24-04-2024
Publisher
Springer US
Published in
Current Cardiology Reports
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-024-02057-y