{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:31:03Z","timestamp":1773387063157,"version":"3.50.1"},"reference-count":100,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Soc. Bras. Med. Trop."],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:p>INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and\/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.<\/jats:p>","DOI":"10.1590\/s0037-86822012000200020","type":"journal-article","created":{"date-parts":[[2012,4,25]],"date-time":"2012-04-25T09:16:08Z","timestamp":1335345368000},"page":"243-252","source":"Crossref","is-referenced-by-count":31,"title":["Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease"],"prefix":"10.1590","volume":"45","author":[{"given":"Luiz Fernando","family":"Junqueira Junior","sequence":"first","affiliation":[{"name":"Universidade de Brasilia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S1473-3099(01)00065-2","article-title":"Clinical and epidemiological aspects of Chagas' disease","volume":"1","author":"Prata A","year":"2001","journal-title":"Lancet Infect Dis"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1586\/14787210.5.4.727","article-title":"An update on the management of Chagas cardiomyopathy","volume":"5","author":"Rocha MO","year":"2007","journal-title":"Expert Rev Anti Infect Ther"},{"key":"ref3","series-title":"Reporte del grupo de trabajo cient\u00edfico sobre La enfermedad de Chagas","year":"2007"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.pcad.2009.11.008","article-title":"Chagas cardiomyopathy: Where do we stand after a hundred years?","volume":"52","author":"Biolo A","year":"2010","journal-title":"Prog Cardiovasc Dis","ISSN":"https:\/\/id.crossref.org\/issn\/0033-0620","issn-type":"print"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1056\/NEJM199308263290909","article-title":"American trypanosomiasis (Chagas' disease): A tropical disease now in the United States","volume":"329","author":"Kirchhoff LV","year":"1993","journal-title":"N Engl J Med","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1093\/eurheartj\/ehn424","article-title":"Chagas cardiomyopathy: Europe is not spared!","volume":"29","author":"Guerri-Guttenberg RA","year":"2008","journal-title":"Eur Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0195-668X","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1590\/S0037-86821989000300007","article-title":"The indeterminate form of human chronic Chagas' disease: a clinical epidemiological review","volume":"22","author":"Dias JC","year":"1989","journal-title":"Rev Soc Bras Med Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S1566-0702(02)00014-0","article-title":"Impaired autonomic control of heart interval changes to Valsalva manoeuvre in Chagas' disease without overt manifestation","volume":"97","author":"Junqueira Jr LF","year":"2002","journal-title":"Auton Neurosci"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1111\/j.1540-8159.2007.00749.x","article-title":"Cardiac autonomic modulation evaluated by heart interval variability is unaltered but subtly widespread in the indeterminate Chagas' disease","volume":"30","author":"Correia D","year":"2007","journal-title":"Pacing Clin Electrophysiol","ISSN":"https:\/\/id.crossref.org\/issn\/0147-8389","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jelectrocard.2008.10.007","article-title":"Distinctive impaired cardiac autonomic modulation of heart rate variability in chronic Chagas' indeterminate and heart diseases","volume":"42","author":"Vasconcelos DF","year":"2009","journal-title":"J Eletrocardiol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0065-308X(08)60472-8","article-title":"Chagas' disease and Chagas' syndrome: the pathology of American trypanosomiasis","volume":"6","author":"K\u00f6berle F","year":"1968","journal-title":"Adv Parasitol","ISSN":"https:\/\/id.crossref.org\/issn\/0065-308X","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/0002-8703(78)90362-9","article-title":"Histopathology of the conducting tissue of the heart in Chagas' myocarditis","volume":"95","author":"Andrade ZA","year":"1978","journal-title":"Am Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0002-8703","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1590\/S0037-86821983000400007","article-title":"Involvement of the autonomic nervous system in Chagas' heart disease","volume":"16","author":"Lopes ER","year":"1983","journal-title":"Rev Soc Bras Med Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/0002-8703(90)90191-Y","article-title":"Microvascular changes as a cause of chronic cardiomyopathy in Chagas' disease","volume":"120","author":"Rossi MA","year":"1990","journal-title":"Am Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0002-8703","issn-type":"print"},{"key":"ref15","first-page":"23","article-title":"Resposta inflamat\u00f3ria na fase cr\u00f4nica da forma adquirida da doen\u00e7a de Chagas","volume":"31","author":"Lopes ER","year":"2002","journal-title":"Rev Pat Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0301-0406","issn-type":"print"},{"key":"ref16","first-page":"429","article-title":"Sobre o poss\u00edvel papel da disfun\u00e7\u00e3o auton\u00f4mica card\u00edaca na morte s\u00fabita associada \u00e0 doen\u00e7a de Chagas","volume":"56","author":"Junqueira Jr LF","year":"1991","journal-title":"Arq Bras Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0066-782X","issn-type":"print"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1161\/CIRCULATIONAHA.106.624296","article-title":"Pathogenesis of chronic Chagas' heart disease","volume":"115","author":"Marin-Neto JA","year":"2007","journal-title":"Circulation","ISSN":"https:\/\/id.crossref.org\/issn\/0009-7322","issn-type":"print"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/0002-8703(85)90222-4","article-title":"A natural human model of intrinsic heart nervous system denervation: Chagas' cardiopathy","volume":"110","author":"Oliveira JSM","year":"1985","journal-title":"Am Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0002-8703","issn-type":"print"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1590\/S0074-02762009000900021","article-title":"Chagas' heart disease: pathophysiologic mechanisms, prognostic factors and risk stratification","volume":"104","author":"Rassi Jr A","year":"2009","journal-title":"Mem Inst Oswaldo Cruz","ISSN":"https:\/\/id.crossref.org\/issn\/0074-0276","issn-type":"print"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1590\/S0074-02761984000500016","article-title":"The canine model of Chagas' disease","volume":"79","author":"Andrade Z","year":"1984","journal-title":"Mem Inst Oswaldo Cruz","ISSN":"https:\/\/id.crossref.org\/issn\/0074-0276","issn-type":"print"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1590\/S0036-46651991000500001","article-title":"Neuronal counting and parasympathetic dysfunction in the hearts of chronically Trypanosoma cruzi-infected rats","volume":"33","author":"Chapadeiro E","year":"1991","journal-title":"Rev Inst Med Trop S\u00e3o Paulo","ISSN":"https:\/\/id.crossref.org\/issn\/0036-4665","issn-type":"print"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1590\/S0037-86821999000100007","article-title":"Depopula\u00e7\u00e3o neuronal card\u00edaca em hamsters (Mesocricetus auratus) cronicamente infectados com o Trypanosoma cruzi","volume":"32","author":"Chapadeiro E","year":"1999","journal-title":"Rev Soc Bras Med Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref23","first-page":"314","article-title":"Cardiac autonomic dysfunction and neuroganglionitis in a rat model of chronic Chagas' disease","volume":"26","author":"Junqueira Jr LF","year":"1992","journal-title":"Cardiovasc Res","ISSN":"https:\/\/id.crossref.org\/issn\/0008-6363","issn-type":"print"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1179\/000349802125000583","article-title":"Cardiac denervation in mice infected with Trypanosoma cruzi","volume":"96","author":"Rodrigues E","year":"2002","journal-title":"Ann Trop Med Parasitol","ISSN":"https:\/\/id.crossref.org\/issn\/0003-4983","issn-type":"print"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0001-706X(01)00202-9","article-title":"Pathogenesis of Chagas' heart disease: role of autoimmunity","volume":"81","author":"Engman DM","year":"2002","journal-title":"Acta Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0001-706X","issn-type":"print"},{"key":"ref26","first-page":"92","article-title":"Hipot\u00e1lamo anterior na mol\u00e9stia de Chagas humana","volume":"13","author":"Britto-Costa R","year":"1971","journal-title":"Rev Inst Med Trop S\u00e3o Paulo","ISSN":"https:\/\/id.crossref.org\/issn\/0036-4665","issn-type":"print"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/0167-5273(96)02592-2","article-title":"Antiadrenergic and muscarinic receptor antibodies in Chagas' cardiomyopathy","volume":"54","author":"Borda ES","year":"1996","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.pcad.2005.01.003","article-title":"Postmortem studies of the intertruncal plexus and cardiac conduction system from patients with Chagas' disease who died suddenly","volume":"47","author":"James TN","year":"2005","journal-title":"Prog Cardiovasc Dis","ISSN":"https:\/\/id.crossref.org\/issn\/0033-0620","issn-type":"print"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ijcard.2005.07.032","article-title":"Changes in the cardiac beta adrenergic system provoked by different T. cruzi strains","volume":"111","author":"Lo Presti MS","year":"2006","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/S0002-9149(00)01133-4","article-title":"Relation of regional sympathetic denervation and myocardial perfusion disturbance to wall motion impairment in Chagas' cardiomyopathy","volume":"86","author":"Sim\u00f5es MV","year":"2000","journal-title":"Am J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9149","issn-type":"print"},{"key":"ref31","first-page":"48","article-title":"Chagas' heart disease as an experimental model for studies of cardiac autonomic function in man","volume":"57","author":"Amorim DS","year":"1982","journal-title":"Mayo Clin Proc","ISSN":"https:\/\/id.crossref.org\/issn\/0025-6196","issn-type":"print"},{"key":"ref32","first-page":"171","article-title":"Subtle cardiac autonomic impairment in Chagas' disease detected by baroreflex sensitivity testing","volume":"18","author":"Junqueira Jr LF","year":"1985","journal-title":"Braz J Med Biol Res","ISSN":"https:\/\/id.crossref.org\/issn\/0100-879X","issn-type":"print"},{"key":"ref33","first-page":"1091","article-title":"Ambulatory assessment of cardiac autonomic function in Chagas' heart disease patients based on indexes of R-R interval variation in the Valsalva maneuver","volume":"23","author":"Junqueira Jr LF","year":"1990","journal-title":"Braz J Med Biol Res","ISSN":"https:\/\/id.crossref.org\/issn\/0100-879X","issn-type":"print"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0167-5273(98)00132-6","article-title":"Cardiac autonomic impairment and early myocardial damage involving the right ventricle are independent phenomena in Chagas' disease","volume":"65","author":"Marin-Neto JA","year":"1998","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1067\/mhj.2001.111406","article-title":"Parasympathetic dysautonomia precedes left ventricular systolic dysfunction in Chagas' disease","volume":"141","author":"Ribeiro ALP","year":"2001","journal-title":"Am Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0002-8703","issn-type":"print"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s10286-009-0044-z","article-title":"The Valsalva maneuver in Chagas disease patients without cardiopathy","volume":"20","author":"Ribeiro ALP","year":"2010","journal-title":"Clin Auton Res","ISSN":"https:\/\/id.crossref.org\/issn\/0959-9851","issn-type":"print"},{"key":"ref37","first-page":"111","article-title":"Cardiac autonomic and ventricular mechanical functions in asymptomatic chronic chagasic cardiomyopathy","volume":"98","author":"Vasconcelos DF","year":"2012","journal-title":"Arq Bras Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0066-782X","issn-type":"print"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4269\/ajtmh.2011.10-0303","article-title":"Autonomic dysfunction and risk factors associated with Trypanosoma cruzi infection among children in Arequipa, Peru","volume":"84","author":"Bowman NM","year":"2011","journal-title":"Am J Trop Med Hyg","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9637","issn-type":"print"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.actatropica.2005.10.006","article-title":"Cardiac autonomic modulation in hypertensive patients with Chagas' disease","volume":"97","author":"Miziara AN","year":"2006","journal-title":"Acta Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0001-706X","issn-type":"print"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.autneu.2006.05.005","article-title":"Cardiac autonomic function in chagasic elderly patients in an endemic area: a time and frequency domain analysis approach","volume":"131","author":"Resende LA","year":"2007","journal-title":"Auton Neurosci"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.ijcard.2009.10.002","article-title":"Vagal impairment in elderly Chagas' disease patients: a population-based study (The Bambu\u00ed Study)","volume":"147","author":"Ribeiro ALP","year":"2011","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref42","first-page":"153","article-title":"Envolvimento do n\u00f3dulo sinusal na doen\u00e7a de Chagas","volume":"50","author":"Andrade ZA","year":"1988","journal-title":"Arq Bras Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0066-782X","issn-type":"print"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1161\/01.HYP.36.6.1035","article-title":"Decreased cardiopulmonary baroreflex sensitivity in Chagas' heart disease","volume":"36","author":"Consolim-Colombo FM","year":"2000","journal-title":"Hypertension","ISSN":"https:\/\/id.crossref.org\/issn\/0194-911X","issn-type":"print"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1161\/hc4001.097039","article-title":"Dysregulation of peripheral and central chemoreflex responses in Chagas' heart disease patients without heart failure","volume":"104","author":"Barreto-Filho JAS","year":"2001","journal-title":"Circulation","ISSN":"https:\/\/id.crossref.org\/issn\/0009-7322","issn-type":"print"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0167-5273(96)02878-1","article-title":"Sudden and unexpected death in clinically silent Chagas' disease","volume":"58","author":"Baroldi G","year":"1997","journal-title":"A hypothesis. Int J Cardiol"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/S0002-9149(01)01477-1","article-title":"Heart rate dynamics before the spontaneous onset of ventricular tachyarrhythmias in Chagas' heart disease","volume":"87","author":"D\u00edaz JO","year":"2001","journal-title":"Am J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9149","issn-type":"print"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"727","DOI":"10.7326\/0003-4819-91-5-727","article-title":"Cardiac ganglionitis associated with sudden unexpected death","volume":"91","author":"James T","year":"1979","journal-title":"Ann Int Med"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1136\/hrt.71.1.16","article-title":"Decreased heart rate variability in survivors of sudden cardiac death not associated with coronary heart disease","volume":"71","author":"Fei L","year":"1994","journal-title":"Brit Heart J"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1161\/01.CIR.102.11.1239","article-title":"Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes","volume":"12","author":"Dekker JM","year":"2000","journal-title":"The ARIC study. Circulation"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S0008-6363(01)00221-8","article-title":"Sudden cardiac death: role of heart rate variability to identify patients at risk","volume":"5","author":"Lombardi F","year":"2001","journal-title":"Cardiovasc Res","ISSN":"https:\/\/id.crossref.org\/issn\/0008-6363","issn-type":"print"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S0002-9149(00)01312-6","article-title":"Fractal analysis and time-and frequency-domain measures of heart rate variability as predictors of mortality in patients with heart failure","volume":"87","author":"M\u00e4kikallio TH","year":"2001","journal-title":"Am J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9149","issn-type":"print"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4065\/77.1.45","article-title":"Autonomic tone as a cardiovascular risk factor: the dangers of chronic fight or flight","volume":"77","author":"Curtis BM","year":"2002","journal-title":"Mayo Clin Proc","ISSN":"https:\/\/id.crossref.org\/issn\/0025-6196","issn-type":"print"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1093\/europace\/eum272","article-title":"Significance of cardiac autonomic neuropathy in risk stratification of Brugada syndrome","volume":"10","author":"Bigi MAB","year":"2008","journal-title":"Europace"},{"key":"ref54","first-page":"479","article-title":"Anatomic causes of cardiac insufficiency in chronic chagasic cardiopathy (myocarditis) studied in comparison to anatomic causes of cardiac insufficiency in other cardiopathies: Part II","volume":"29","author":"Bogliolo L","year":"1976","journal-title":"Arq Bras Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0066-782X","issn-type":"print"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/0167-5273(88)90217-3","article-title":"Parasympathetic impairment in Chagas' heart disease: cause or consequence?","volume":"21","author":"Oliveira JSM","year":"1988","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref56","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/BF01618384","article-title":"Chagas' cadioneuropathy: cardiovascular autonomic dysfunction as the first manifestation of the disease","volume":"7","author":"Puigb\u00f3 JJ","year":"1998","journal-title":"Int J Angiol"},{"key":"ref57","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1542-474X.2006.00054.x","article-title":"Chronotropic incompetence and abnormal autonomic modulation in ambulatory Chagas disease patients","volume":"11","author":"Rocha AL","year":"2006","journal-title":"Ann Non-invasive Electrocardiol"},{"key":"ref58","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.eupc.2005.02.114","article-title":"Heart rate turbulence and left ventricular ejection fraction in Chagas disease","volume":"7","author":"Tundo F","year":"2005","journal-title":"Europace"},{"key":"ref59","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.ijcard.2003.06.015","article-title":"A modified and unifying neurogenic hypothesis can explain the natural history of chronic Chagas heart disease","volume":"96","author":"D\u00e1vila DF","year":"2004","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref60","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1590\/S0037-86821975000600001","article-title":"Contribui\u00e7\u00e3o ao estudo da anatomia patol\u00f3gica dos cora\u00e7\u00f5es de chag\u00e1sicos falecidos subitamente","volume":"9","author":"Lopes ER","year":"1975","journal-title":"Rev Soc Bras Med Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1590\/S0066-782X2001000100008","article-title":"Sudden death in Chagas' disease","volume":"76","author":"Rassi Jr A","year":"2001","journal-title":"Arq Bras Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0066-782X","issn-type":"print"},{"key":"ref62","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/00001573-200401000-00003","article-title":"Autonomic aspects of arrhythmogenesis: the enduring and the new","volume":"9","author":"Verrier RL","year":"2004","journal-title":"Curr Opinion Cardiol"},{"key":"ref63","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/j.1540-8167.2006.00590.x","article-title":"New perspectives on the role of autonomic nervous system in the genesis of arrhythmias","volume":"18","author":"Chen LS","year":"2006","journal-title":"J Cardiovasc Electrophysiol","ISSN":"https:\/\/id.crossref.org\/issn\/1045-3873","issn-type":"print"},{"key":"ref64","doi-asserted-by":"crossref","first-page":"504","DOI":"10.2967\/jnumed.110.082032","article-title":"Sustained ventricular tachycardia is associated with regional myocardial sympathetic denervation assessed with 123I-metaiodobenzylguanidine in chronic Chagas cardiomyopathy","volume":"52","author":"Miranda CH","year":"2011","journal-title":"J Nucl Med","ISSN":"https:\/\/id.crossref.org\/issn\/0161-5505","issn-type":"print"},{"key":"ref65","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1097\/RLU.0b013e31821772a9","article-title":"Iodine-123 metaiodobenzylguanidine cardiac imaging as a method to detect early sympathetic neuronal dysfunction in chagasic patients with normal or borderline electrocardiogram and preserved ventricular function","volume":"36","author":"Landesmann MCP","year":"2011","journal-title":"Clin Nucl Med","ISSN":"https:\/\/id.crossref.org\/issn\/0363-9762","issn-type":"print"},{"key":"ref66","doi-asserted-by":"crossref","first-page":"20","DOI":"10.4269\/ajtmh.1978.27.20","article-title":"Recovery from heart norepinephrine depletion in experimental Chagas' disease","volume":"27","author":"Machado CR","year":"1978","journal-title":"Am J Trop Med Hyg","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9637","issn-type":"print"},{"key":"ref67","first-page":"1019","article-title":"Chronotropic responses to acetylcholine in atria of mice chronically infected with Y and CL strains of Trypanosoma cruzi","volume":"21","author":"Pereira Fe","year":"1988","journal-title":"Braz J Med Biol Res","ISSN":"https:\/\/id.crossref.org\/issn\/0100-879X","issn-type":"print"},{"key":"ref68","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/S0002-9149(01)02263-9","article-title":"Power-law behavior of heart rate variability in Chagas' disease","volume":"89","author":"Ribeiro ALP","year":"2002","journal-title":"Am J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9149","issn-type":"print"},{"key":"ref69","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/0002-9149(90)90503-S","article-title":"Circadian rhythm of heart rate variability after acute myocardial infarction and its influence on the prognostic value of heart rate variability","volume":"66","author":"Malik M","year":"1990","journal-title":"Am J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9149","issn-type":"print"},{"key":"ref70","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1056\/NEJMoa053241","article-title":"Development and validation of a risk score for predicting death in Chagas' heart disease","volume":"355","author":"Rassi Jr A","year":"2006","journal-title":"New Engl J Med"},{"key":"ref71","first-page":"81","article-title":"Heart rate variability and non-linear dynamics in risk stratification","volume":"2","author":"Perki\u00f6m\u00e4ki JS","year":"2011","journal-title":"Front Physio"},{"key":"ref72","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1093\/cvr\/21.12.922","article-title":"Functional evaluation of sympathetic and parasympathetic system in Chagas' disease using dynamic exercise","volume":"21","author":"Gallo Jr L","year":"1987","journal-title":"Cardiovasc Res","ISSN":"https:\/\/id.crossref.org\/issn\/0008-6363","issn-type":"print"},{"key":"ref73","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1136\/hrt.55.2.204","article-title":"Effect of parasympathetic impairment on the haemodynamic responses to handgrip in Chagas' heart disease","volume":"55","author":"Marin-Neto JA","year":"1986","journal-title":"Brit Heart J"},{"key":"ref74","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1159\/000169734","article-title":"Postural reflexes in chronic Chagas' heart disease: heart rate and arterial pressure responses","volume":"60","author":"Marin-Neto JA","year":"1975","journal-title":"Cardiology","ISSN":"https:\/\/id.crossref.org\/issn\/0008-6312","issn-type":"print"},{"key":"ref75","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1093\/cvr\/14.9.541","article-title":"Mechanisms of tachycardia on standing: studies in normal individuals and in chronic Chagas' heart patients","volume":"14","author":"Marin-Neto JA","year":"1980","journal-title":"Cardiovasc Res","ISSN":"https:\/\/id.crossref.org\/issn\/0008-6363","issn-type":"print"},{"key":"ref76","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1007\/BF01478139","article-title":"Distinctive abnormal responses to tilting test in chronic Chagas' disease","volume":"8","author":"Palmero H","year":"1980","journal-title":"Klin Wochenschr","ISSN":"https:\/\/id.crossref.org\/issn\/0023-2173","issn-type":"print"},{"key":"ref77","first-page":"27","article-title":"Estudio del reflejo barorreceptor en la enfermedad de Chagas","volume":"40","author":"Caeiro TF","year":"1980","journal-title":"Medicina","ISSN":"https:\/\/id.crossref.org\/issn\/0025-7680","issn-type":"print"},{"key":"ref78","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/0167-5273(88)90053-8","article-title":"Valsalva maneuver: a test of the functional state of cardiac innervations in chagasic myocarditis","volume":"18","author":"Fuenmayor AJ","year":"1988","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref79","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/S0167-5273(03)00197-9","article-title":"Valsalva maneuver in chagasics patients with documented past medical history of acute chagasic myocarditis","volume":"93","author":"Odreman RO","year":"2004","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref80","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1016\/0002-8703(91)90019-E","article-title":"Impaired heart rate variability in patients with chronic Chagas' disease","volume":"121","author":"Guzzetti S","year":"1991","journal-title":"Am Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0002-8703","issn-type":"print"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1063\/1.166091","article-title":"Age-related changes in the complexity of cardiovascular dynamics: a potential marker of vulnerability to disease","volume":"5","author":"Lipsitz LA","year":"1995","journal-title":"Chaos"},{"key":"ref82","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/0149-7634(94)00066-A","article-title":"Cardiac vagal tone: a physiological index of stress","volume":"19","author":"Porges SW","year":"1995","journal-title":"Neurosci Biobehav Rev","ISSN":"https:\/\/id.crossref.org\/issn\/0149-7634","issn-type":"print"},{"key":"ref83","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/00006842-199901000-00009","article-title":"Psychosocial factors and heart rate variability in healthy women","volume":"61","author":"Horsten M","year":"1999","journal-title":"Psychosomatic Med"},{"key":"ref84","doi-asserted-by":"crossref","first-page":"S370","DOI":"10.1007\/s00592-003-0122-y","article-title":"Clinical consequences of cardiovascular autonomic neuropathy in diabetic patients","volume":"40","author":"Jermendy G","year":"2003","journal-title":"Acta Diabetol","ISSN":"https:\/\/id.crossref.org\/issn\/0940-5429","issn-type":"print"},{"key":"ref85","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1590\/S0037-86821985000200005","article-title":"Increased osmotic sensitivity for antidiuretic response in chronic Chagas' disease","volume":"18","author":"Veiga JPR","year":"1985","journal-title":"Rev Soc Bras Med Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref86","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1590\/S0037-86821995000100002","article-title":"Effects of water deprivation on renal hydroelectrolytic excretion in chronically Trypanosoma cruzi-infected rats","volume":"28","author":"Rosa TT","year":"1995","journal-title":"Rev Soc Bras Med Trop","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref87","first-page":"62","article-title":"Chronotropic and blood pressure response to oral glucose load in Chagas' disease","volume":"112","author":"Guariento ME","year":"1994","journal-title":"Rev Paulista Med"},{"key":"ref88","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0167-5699(00)01635-2","article-title":"Neural immunoregulation: emerging roles for nerves in immune homeostasis and disease","volume":"21","author":"Downing JEG","year":"2000","journal-title":"Immunol Today","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5699","issn-type":"print"},{"key":"ref89","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1111\/j.1540-8159.2010.03025.x","article-title":"The relationship between heart rate variability and serum cytokines in chronic chagasic patients with persistent parasitemia","volume":"34","author":"Llaguno M","year":"2011","journal-title":"Pacing Clin Electrophysiol","ISSN":"https:\/\/id.crossref.org\/issn\/0147-8389","issn-type":"print"},{"key":"ref90","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1080\/10253890701419886","article-title":"Resilience and vagal tone predict cardiac recovery from acute social stress","volume":"10","author":"Souza GG","year":"2007","journal-title":"Stress","ISSN":"https:\/\/id.crossref.org\/issn\/0228-1201","issn-type":"print"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1590\/S0004-282X1994000200008","article-title":"Cognitive impairment in human chronic Chagas' disease","volume":"52","author":"Mangone CA","year":"1994","journal-title":"Arq Neuropsiquiatr","ISSN":"https:\/\/id.crossref.org\/issn\/0004-282X","issn-type":"print"},{"key":"ref92","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1159\/000182819","article-title":"A population-based study of the association between Trypanosoma cruzi infection and cognitive impairment in old age (the Bambu\u00ed study)","volume":"32","author":"Lima-Costa MF","year":"2009","journal-title":"Neuroepidemiology","ISSN":"https:\/\/id.crossref.org\/issn\/0251-5350","issn-type":"print"},{"key":"ref93","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s10286-009-0035-0","article-title":"Cardiac autonomic modulation and cognitive status in Alzheimer's disease","volume":"20","author":"Toledo MAV","year":"2010","journal-title":"Clin Auton Res","ISSN":"https:\/\/id.crossref.org\/issn\/0959-9851","issn-type":"print"},{"key":"ref94","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/0002-8703(91)90525-M","article-title":"Chagas' cardioneuropathy: effect of ganglioside treatment in chronic dysautonomic patients -a randomized, double-blind, parallel, placebo-controlled study","volume":"122","author":"Iosa D","year":"1991","journal-title":"Am Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0002-8703","issn-type":"print"},{"key":"ref95","first-page":"189","article-title":"Long-term treatment of chronic chagasic cardioneuropathy with a mixture of gangliosides: effect on evolution of circulating anti-GM1 antibodies","volume":"34","author":"Mitelman J","year":"1999","journal-title":"J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0914-5087","issn-type":"print"},{"key":"ref96","doi-asserted-by":"crossref","first-page":"257","DOI":"10.2217\/17460751.2.3.257","article-title":"Cellular therapy in Chagas' disease: potential application in patients with chronic cardiomyopathy","volume":"2","author":"Soares MB","year":"2007","journal-title":"Regen Med"},{"key":"ref97","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.ijcard.2010.05.033","article-title":"Effects of B-Blockers on outcome of patients with Chagas' cardyomiopathy with chronic heart failure","volume":"151","author":"Bestetti RB","year":"2011","journal-title":"Int J Cardiol","ISSN":"https:\/\/id.crossref.org\/issn\/0167-5273","issn-type":"print"},{"key":"ref98","series-title":"Efeitos, em curto prazo, do carvedilol combinado com tratamento convencional sobre a evolu\u00e7\u00e3o cl\u00ednica e o controle auton\u00f4mico do cora\u00e7\u00e3o em portadores de insufici\u00eancia card\u00edaca","author":"Silva de Arruda HMB","year":"2002"},{"key":"ref99","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.cardfail.2005.06.435","article-title":"Changes in heart rate variability are correlated to hemodynamic improvement with chronic carvedilol therapy in heart failure","volume":"11","author":"Bullinga JR","year":"2005","journal-title":"J Card Fail","ISSN":"https:\/\/id.crossref.org\/issn\/1071-9164","issn-type":"print"},{"key":"ref100","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ahj.2006.12.017","article-title":"A randomized trial of carvedilol after renin-angiotensin system inhibition in chronic Chagas cardiomiopathy","volume":"153","author":"Botoni FA","year":"2007","journal-title":"Am Heart J","ISSN":"https:\/\/id.crossref.org\/issn\/0002-8703","issn-type":"print"}],"container-title":["Revista da Sociedade Brasileira de Medicina Tropical"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rsbmt\/v45n2\/v45n2a20.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T05:30:04Z","timestamp":1495863004000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0037-86822012000200020&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,4]]},"references-count":100,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,4]]}},"alternative-id":["S0037-86822012000200020"],"URL":"https:\/\/doi.org\/10.1590\/s0037-86822012000200020","relation":{},"ISSN":["0037-8682"],"issn-type":[{"value":"0037-8682","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,4]]}}}