CHAGAS HEART-DISEASE AND THE AUTONOMIC NERVOUS-SYSTEM

The autonomic nervous system is abnormal in patients with advanced Cha gas' heart disease. Most researchers consider these autonomic abnormal ities as primary, specific and irreversible. However, when and why the se abnormalities appear in the natural history of Chagas' disease, is still the subject of intense controversy. Recent morphological and fun ctional studies strongly suggest that the sympathetic;and the parasymp athetic abnormalities are preceded by myocardial damage and left ventr icular dysfunction. Moreover, chagasic patients with cardiac failure b enefit from drugs which antagonize neurohumoral activation. Consequent ly, the abnormalities of the autonomic nervous system of chagasic pati ents are very likely secondary and partially reversible. (C) 1998 Else vier Science Ireland Ltd. All rights reserved.