{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:00Z","timestamp":1787027280220,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to provide a comprehensive analysis of clinical and epidemiological data related to Chronic Chagas Cardiomyopathy (CCC) in the Amazon region of Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A review of observational, retrospective, and cross-sectional studies related to Chagas Disease in the Amazon region of Brazil was conducted, and a case series addressing CCC in patients treated at the FMT-HVD outpatient clinic, a reference center for Chagas disease in Brazil, was carried out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinical characteristics of 55 patients from the Amazon region with CCC were described. The most common electrocardiographic alteration observed was abnormal ventricular repolarization (AVR), present in 40% of cases. The most common echocardiographic finding was left ventricular systolic dysfunction (49%), followed by akinesia or hypokinesia of the inferior and\/or inferolateral walls (38.1%) and the presence of an apical aneurysm (32.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, this study demonstrates that CCC in the Amazon region presents clinical characteristics and severity that are similar to those observed in other regions. However, certain peculiarities, such as the frequency of right bundle branch block (RBBB) and anterior and septal involvement during the acute phase, require additional investigation to better comprehend the disease in the region. Overall, the study provides crucial clinical insights for the diagnosis and treatment of CCC in the Amazon region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2023.1284639","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T01:55:35Z","timestamp":1701050135000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Chronic Chagas Cardiomyopathy in the Brazilian Amazon region: clinical characteristics and regional distinctiveness"],"prefix":"10.3389","volume":"11","author":[{"given":"Elsa Isela","family":"Guevara Moctezuma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Smith Doria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Vanina","family":"Ortiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9bora Raysa","family":"Teixeira de Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Irungu","family":"Mwangi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"do Nascimento Couceiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba Regina Jorge","family":"Brand\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Augusto de Oliveira","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria das Gra\u00e7as","family":"Vale Barbosa Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Marcos","family":"Barbosa Bemfica Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/S1474-4422(10)70042-9","article-title":"Chagas disease and stroke","volume":"9","author":"Carod-Artal","year":"2010","journal-title":"Lancet Neurol."},{"key":"B2","year":"2021","journal-title":"Chagas Disease (American trypanosomiasis)."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5123\/S1679-49742016002100002","article-title":"II Consenso Brasileiro em Doen\u00e7a de Chagas, 2015","volume":"25","author":"Carlos Pinto Dias","year":"2016","journal-title":"Epidemiologia e Servi\u00e7os de Sa\u00fade."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1590\/S0074-02762009000700021","article-title":"A new consensus for Trypanosoma cruzi intraspecific nomenclature: second revision meeting recommends TcI to TcVI","volume":"104","author":"Zingales","year":"2009","journal-title":"Mem Inst Oswaldo Cruz."},{"key":"B5","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1590\/S0036-46651993000200001","article-title":"Central nervous system involvement in Chagas' disease: an updating","volume":"35","author":"Pittella","year":"1993","journal-title":"Rev Inst Med Trop S\u00e1o Paulo."},{"key":"B6","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1590\/S0036-46651993000200014","article-title":"Trypanosoma cruzi meningoencephalitis and myocarditis in a patient with acquired immunodeficiency syndrome","volume":"35","author":"Rocha","year":"1993","journal-title":"Rev Inst Med Trop S\u00e1o Paulo."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e20230269","DOI":"10.36660\/abc.20230269","article-title":"SBC guideline on the diagnosis and treatment of patients with cardiomyopathy of chagas disease \u2013 2023","volume":"120","author":"Marin-Neto","year":"2023","journal-title":"Arq Bras Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1146\/annurev-pathol-020117-043711","article-title":"Pathology and pathogenesis of Chagas heart disease","volume":"14","author":"Bonney","year":"2019","journal-title":"Annu Rev Pathol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"173","DOI":"10.5935\/2359-4802.20180011","article-title":"Chagas disease cardiomyopathy","volume":"31","author":"Sim\u00f5es","year":"2018","journal-title":"Int J Cardiovas Sci"},{"key":"B10","author":"Minist\u00e9rio da Sa\u00fade","year":"2022","journal-title":"Boletim Epidemiol\u00f3gico; 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