Pathogenesis of cardiac neuro-myopathy in Chagas' disease and the role of the autonomic nervous system.

Millions of people in Latin America are affected by Chagas' disease. Because of its lengthy evolution its symptoms begin to be noticed in the third decade when the person is in the fullness of life. From Mexico to Argentina, Chagas' disease is an endemic cardioneuromyopathy and the population exposed to the disease is about 65 million people [1]. The disease is transmitted: (a) by trypanosome infestation, the transmitting agent par excellence in endemic areas: (b) blood transfusion from a positive donor; (c) through the placenta. Moreover, thousands of infected individuals have migrated to the U.S.A., Canada and Europe, but there are very few data on the spread of Chagas' disease in these countries [2]. In spite of its severity and its endemic distribution Chagas' disease, first described by Carlos Chagas in Brazil in 1909, has a poorly understood pathogenesis. Over a period of 10 years we have carried out a systematic study of the involvement of the autonomic nervous system, by investigating the