Cardiac Autonomic Control Mechanisms in the Pathogenesis of Chagas Heart Disease英文文献资料.docVIP

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Cardiac Autonomic Control Mechanisms in the Pathogenesis of Chagas Heart Disease英文文献资料.doc

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Cardiac Autonomic Control Mechanisms in the Pathogenesis of Chagas Heart Disease英文文献资料

HindawiPublishingCorporation InterdisciplinaryPerspectivesonInfectiousDiseases Volume2012,ArticleID980739,8pages doi:10.1155/2012/980739 ReviewArticle CardiacAutonomicControlMechanismsinthePathogenesisof Chagas’HeartDisease DiegoF.Da′vila,JoseH.Donis,GabrielaAratadeBellabarba,VanesaVillarroel, FranciscoSanchez,LisbethBerrueta,SihamSalmen,andBarbaraDasNeves InstitutodeInvestigacionesCardiovasculares,DepartamentodeFisiopatolog′?a,InstitutodeInmunolog`?aClinica, FacultaddeMedicina,HospitalUniversitariodeLosAndes,UniversidaddeLosAndes,M′erida5101,Venezuela CorrespondenceshouldbeaddressedtoDiegoF.D′avila,diegod@ula.ve Received1June2012;Accepted27August2012 AcademicEditor:DecioDiament Copyright?2012DiegoF.D′avilaetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Primaryabnormalitiesoftheautonomicnervoussystemhadbeenpostulatedasthepathogenicmechanismsofmyocardialdamage, inpatientswithChagasdisease.However,recentinvestigationsindicatethattheseabnormalitiesaresecondaryandamenableto treatmentwithbeta-adrenergicblockers.Moreover,muscariniccardiacautoantibodiesappeartoenhanceparasympatheticactivity onthesinusnode.Therefore,thepurposeofthispaperistoanalyzehowknowledgeonChagas’diseaseevolvedfrombeinginitially consideredasaprimarycardioneuromyopathytothecurrentstatusofacongestivecardiomyopathyofparasiticorigin. 1.Introduction availabledataareconsideredinsu?cienttojustifytrypanoci- daltherapyasatherapeuticalalternativeaimedatmodi?ng clinicaloutcomes.Nonetheless,theBENEFITtrial(Bene?t Evaluation for Interrupting Trypanosomiasis), currently in progress,willundoubtedlyprovidede?nitiveanswersforthis crucialtherapeuticdilemma[1–4]. ThenaturalhistoryofChagasdiseaseischaracterizedbyan acute phase, followed by an indeterminate or transitional stage and a terminal arrhythmic-congestive phase. This diseaseappearstoevolvefromlocalizedmyocardialdamage t