A modified and unifying neurogenic hypothesis can explain the natural history of chronic Chagas heart disease.
The pathogenesis of chronic Chagas disease still is an unresolved and controversial issue. Parasite persistence and autoimmune responses cannot explain the spectrum of chronic Chagas disease. However, a modified neurogenic hypothesis, concerning the timing and mechanisms responsible for the cardiac parasympathetic damage and for the activation of the sympathetic nervous system and of other neurohormonal systems, unifies cardiac remodelling and neurohormonal activation to explain most of the events of the natural history of Chagas disease.
Dávila
Diego F
DF
Instituto de Investigaciones Cardiovasculares, Departamento de Fisiopatología, Universidad de Los Andes, Apartado Postal 590, 5101 Mérida, Venezuela. diego@ula.ve
Donis
Jose H
JH
Torres
Argenis
A
Ferrer
Jose A
JA
D000818:Animals; D001341:Autonomic Nervous System / Q000502:physiology*; D002598:Chagas Cardiomyopathy / Q000453:epidemiology / Q000503:physiopathology*; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D014349:Trypanosoma cruzi / Q000302:isolation & purification*; D014687:Venezuela / Q000453:epidemiology; D020257:Ventricular Remodeling / Q000502:physiology