Chagas Cardiomyopathy: Evidence in Medical and Nutritional Management

Purpose of Review: Chagas cardiomyopathy (CC) is a prevalent manifestation of Chagas disease, responsible for high mortality. Treatment and management have not changed significantly, and there is still a lack of consensus about the proper approach. Particular characteristics in the pathogenesis and clinical manifestations of CC cause inadequate treatment. This review aims to describe the treatment and management of CC currently indicated and describe topics of discussion and future medical and nutritional interventions. Recent Findings: New evidence suggests benznidazole (BZ) is beneficial in the treatment of CC. Also, posaconazole as adjuvant treatment could be beneficial. ECA inhibitors, β-blockers, and ivabradine show benefit in CC. Amiodarone as treatment of ventricular arrhythmias but also inhibiting Trypanosoma cruzi infection is described. Nutritional supplementation prevents progression of CC as adjuvant therapy. Summary: Treatment in CC cardiomyopathy has not changed over the years; use of benznidazole may be beneficial reducing parasitemia although there is no consistent survival improvement. Novel therapies failed to produce promising results in animal models to human models. Nutritional supplementation plays an important role in reducing proinflammatory cytokines and could be in the in the future adjuvant therapy. Investigation in CC is needed to address important topics. © 2018, Springer International Publishing AG, part of Springer Nature.