Dilated Cardiomyopathy

Chagas Heart Failure in Patients from Latin America

More than a century after its discovery, Chagas disease still is a major health problem in Latin America, with 5.7 million people in 21 countries being affected by it.1 Moreover, about 70 million people are at risk of acquiring the illness.1 Cases of Chagas disease are now found globally; there are more than 400,000 immigrants with this disease living in Europe (mainly in Spain, Italy and France) and the United States.2 The consequence of this is that the annual global (direct plus indirect) cost of the disease is in the region of US $7.2 b

The Role of Cardiovascular Magnetic Resonance Imaging in Heart Failure

Heart failure (HF) can be defined haemodynamically as any abnormality of cardiac structure or function resulting in a failure to deliver oxygen at a rate adequate for tissue requirements, despite normal filling pressures – or only at the expense of increased filling pressures.1 Around half of patients with HF have reduced left ventricle ejection fraction (LVEF; EF <40 %) at rest (HF-REF).2

Left Ventricular Remodelling: A Problem in Search of Solutions

The term cardiac remodelling (REM) is used to define changes that produce geometrical rearrangement of the normal structures of the heart, together with complex biological and molecular alterations. REM affects the heart at the level of the cardiomyocyte, the blood vessels and the extracellular matrix. Proliferation of the latter, resulting in fibrosis, is one of the hallmarks of pathological REM.1,2 REM represents a major cause of heart failure as well as cardiac morbidity and mortality.

Decompensated Heart Failure in Pregnancy

‘Heart failure’ is a term that may be loosely or precisely defined. The development of pulmonary oedema does not necessarily indicate a cardiac cause and of the cardiac causes for pulmonary oedema, not all can be attributed to left ventricular failure.1 The majority of women developing symptoms and signs of heart failure during pregnancy have no known pre-existing cardiomyopathy. This article describes the cardiac causes of pulmonary oedema presenting in pregnancy with reference to other differential diagnoses.