Chagas heart disease is an inflammatory cardiomyopathy that develops in approximately one-third of people infected with the protozoan parasite Trypanosoma cruzi. One way T. cruzi is transmitted to people is through contact with infected kissing bugs, which are found in much of the Western Hemisphere, including in vast areas of the United States. The epidemiology of T. cruzi and Chagas heart disease and the varied mechanisms leading to myocyte destruction, mononuclear cell infiltration, fibrosis, and edema in the heart have been extensively studied by hundreds of scientists for more than 100 years. Despite this wealth of knowledge, it is still impossible to predict what will happen in an individual infected with T. cruzi because of the tremendous variability in clonal parasite virulence and human susceptibility to infection and the lack of definitive molecular predictors of outcome from either side of the host-parasite equation. Further, while several distinct mechanisms of pathogenesis have been studied in isolation, it is certain that multiple coincident mechanisms combine to determine the ultimate outcome. For these reasons, Chagas disease is best considered a collection of related but distinct illnesses. This review highlights the pathology and pathogenesis of the most common adverse sequela of T. cruzi infection-Chagas heart disease-and concludes with a discussion of key unanswered questions and a view to the future.

中文翻译：

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查加斯心脏病的病理学和发病机制。

恰加斯（Chagas）心脏病是一种炎症性心肌病，大约有三分之一的感染了原生动物寄生虫的克氏锥虫感染的人会患上这种病。克氏锥虫传播给人的一种方式是通过接触被感染的接吻臭虫，这种臭虫在西半球的大部分地区（包括美国广大地区）都可以发现。一百多年来，数百名科学家广泛研究了克鲁维氏锥虫和恰加斯州心脏病的流行病学以及导致心肌细胞破坏，单核细胞浸润，纤维化和水肿的各种机制。尽管拥有如此丰富的知识，但仍无法预测感染T的个体会发生什么。Cruzi之所以如此，是因为克隆寄生虫毒力的巨大变异性和人类对感染的易感性，以及宿主-寄生虫方程两边均缺乏明确的分子预测结果的指标。此外，尽管已经单独研究了几种不同的发病机理，但可以肯定的是，多种同时发生的机理结合在一起可以确定最终的结果。由于这些原因，最好将恰加斯病视为相关但截然不同的疾病的集合。这篇综述着重介绍了克氏锥虫感染最常见的后遗症-南美锥虫病-的病理学和发病机理，并以关键的未解决问题的讨论和对未来的展望作为结尾。尽管已经单独研究了几种不同的发病机理，但可以肯定的是，多种同时发生的机理结合在一起可以确定最终的结果。由于这些原因，最好将恰加斯病视为相关但截然不同的疾病的集合。这篇综述着重介绍了克氏锥虫感染最常见的后遗症-南美锥虫病-的病理学和发病机理，并以关键的未解决问题的讨论和对未来的展望作为结尾。尽管已经单独研究了几种不同的发病机理，但可以肯定的是，多种同时发生的机理结合在一起可以确定最终的结果。由于这些原因，最好将恰加斯病视为相关但截然不同的疾病的集合。这篇综述着重介绍了克氏锥虫感染最常见的后遗症-南美锥虫病-的病理学和发病机理，并以关键的未解决问题的讨论和对未来的展望作为结尾。