Chagas cardiomyopathy and ischemic stroke
Neurology Department, Sarah Hospital, SMHS, CEP 7330-150, Brasilia DF, Brazil.Expert Review of Cardiovascular Therapy 02/2006; 4(1):119-30. DOI: 10.1586/14779072.4.1.119
American trypanosomiasis, known as Chagas disease is a major cause of cardiomyopathy in South America. Irreversible damage to the heart can appear 10-20 years after chagasic infection. The relationship between Chagas cardiomyopathy and ischemic stroke has been reviewed. Significant variables that predict ischemic stroke in chagasic patients have been identified: apical aneurysm, cardiac insufficiency, electrocardiogram arrhythmia and female gender. Chagasic cardiomyopathy should be included in the differential diagnosis of the etiology of stroke, being a potential source of cardioembolic stroke.
- European Journal of Neurology 06/2007; 14(5):e8. DOI:10.1111/j.1468-1331.2007.01721.x · 4.06 Impact Factor
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ABSTRACT: Chagas disease, endemic in rural areas of Mexico, Central and South America, is caused by the protozoan parasite, Trypanosma cruzi, which is spread by the Reduviid bug and also by transfusion or organ transplant. Transmission of the organism from asymptomatic donors to immunocompromised recipients, leads to clinically apparent disease. With recent immigration patterns, T. cruzi is now becoming an increasing problem in non-endemic areas of North America and Europe. Blood screening tests for T. cruzi are being developed, and one test is currently licensed by the United States Food and Drug Administration and has been implemented in some US blood centers. This study alternatively investigates the potential for a novel DNA-intercalating photosensitizer, thiopyrylium (TP), to inactivate T. cruzi in red cell suspensions. With complete inactivation using 6.3 microM of TP and 1.1J/cm(2) red light treatment, results suggest that the organism is highly sensitive to photoinactivation under conditions much less stringent than those that have been previously demonstrated to maintain red cell (RBC) properties during 42 day storage.Transfusion and Apheresis Science 09/2007; 37(1):23-5. DOI:10.1016/j.transci.2007.03.014 · 0.77 Impact Factor
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ABSTRACT: American trypanosomiasis, also known as Chagas' disease (CD), is a major public health problem and a frequent cause of chronic cardiomyopathy and stroke in South America. The role of CD as an independent stroke risk factor is reviewed. Chronic cardiomyopathy can appear 10-30 years after the initial infection and affects about 30% of CD patients. Cardiac arrhythmias, congestive heart failure, apical aneurysm and mural thrombus are potential embolic factors that partially explain the genesis of chagasic stroke. Prevalence of apical aneurysm and mural thrombus in CD stroke patients has been estimated in 37 and 11.7%, respectively. Nevertheless, not all stroke chagasic patients have a severe myocardiopathy. Stroke may also be the first manifestation of CD in patients with mild or undetected systolic dysfunction. The diagnosis of CD may be established after stroke presentation in around 40% of patients. Awareness of stroke risk in chagasic patients is very poor and has been estimated in less than 5%. Chagasic cardiomyopathy is a neglected, frequently unrecognized, source of cardioembolic stroke in South America. Educational and prevention programs should be performed in order to prevent this complication of the chronic form of CD.Transactions of the Royal Society of Tropical Medicine and Hygiene 12/2007; 101(11):1075-80. DOI:10.1016/j.trstmh.2007.06.007 · 1.84 Impact Factor
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