Cysticercosis & Heart: A Systematic Review.

Cysticercosis is a parasitic tissue infection caused by larval cysts of the tapeworm Taenia solium. These larval cysts infect brain, muscle, or other tissue, and are a major cause of adult-onset seizures in most low-income countries with tropical climate. Prevalence it's around 50 million people. Although cardiovascular system is not the most affected, this disease can also be associated with multiple and randomly distributed cysts in the subpericardium, subendocardium and myocardium in up to 25% of infected patients. Most cardiac cysticercosis' cases are asymptomatic, but it can manifest with ventricular arrhythmias and conduction disorders. Area Covered: The "Neglected Tropical Diseases and other Infectious Diseases affecting the Heart" (NET-Heart project) is an initiative by the Emerging Leaders group of the Interamerican Society of Cardiology to systematically review all these endemic conditions affecting the heart. A systematic review was conducted following preferred reporting items for systematic review and meta-analysis guidelines and including articles published in MEDLINE, ScienceDirect, PubMed and LILACS databases. A total of 41 papers were included in this review. Expert Opinion: In the areas of greatest prevalence, unhealthiness and poverty favor the development of this disease, which highlights the need to establish global health policies that reduce morbidity and mortality, economic losses of the affected population, and health costs related to hospitalizations for cardiovascular involvement. Authors provide an algorithm to evaluate the possibility of Cysticercosis' cardiovascular complications.

World Heart Federation Roadmap for Digital Health in Cardiology.

More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service delivery. Digital health technologies can help address these challenges. They may be a tool to reach Sustainable Development Goal 3.4 and reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation. World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.

Ambulatory Patients with Cardiometabolic Disease and Without Evidence of COVID-19 During the Pandemic. The CorCOVID LATAM Study.

Background: SARS-CoV-2 pandemic has modified the cardiovascular care of ambulatory patients. The aim of this survey was to study changes in lifestyle habits, treatment adherence, and mental health status in patients with cardiometabolic disease, but no clinical evidence of COVID-19. Methods: A cross-sectional survey was conducted in ambulatory patients with cardiometabolic disease using paper/digital surveys. Variables investigated included socioeconomic status, physical activity, diet, tobacco use, alcohol intake, treatment discontinuation, and psychological symptoms. Results: A total of 4,216 patients (50.9% males, mean age 60.3 ± 15.3 years old) from 13 Spanish-speaking Latin American countries were enrolled. Among the study population, 46.4% of patients did not have contact with a healthcare provider, 31.5% reported access barriers to treatments and 17% discontinued some medication. Multivariate analysis showed that non-adherence to treatment was more prevalent in the secondary prevention group: peripheral vascular disease (OR 1.55, CI 1.08-2.24; p = 0.018), heart failure (OR 1.36, CI 1.05-1.75; p = 0.017), and coronary artery disease (OR 1.29 CI 1.04-1.60; p = 0.018). No physical activity was reported by 38% of patients. Only 15% of patients met minimum recommendations of physical activity (more than 150 minutes/week) and vegetable and fruit intake. Low/very low income (45.5%) was associated with a lower level of physical activity (p < 0.0001), less fruit and vegetables intake (p < 0.0001), more tobacco use (p < 0.001) and perception of depression (p < 0.001). Low educational level was also associated with the perception of depression (OR 1.46, CI 1.26-1.70; p < 0.01). Conclusions: Patients with cardiometabolic disease but without clinical evidence of COVID-19 showed significant medication non-adherence, especially in secondary prevention patients. Deterioration in lifestyle habits and appearance of depressive symptoms during the pandemic were frequent and related to socioeconomic status.

Rabies and the Heart.

As one of the neglected diseases, rabies is as a highly fatal viral infection, most prevalent in low- and middle-income regions, which produces a substantial health and economic burden. It mainly affects the central nervous system causing encephalitis, however extraneuronal involvement has been documented. Cardiac structures may be involved and can play a role in the severity of the disease. Most of the existing literature comes from case reports and case series where cardiac involvement results in myocarditis and cardiac arrhythmias. As part of the "Neglected Tropical Diseases and Other Infectious Diseases Involving the Heart" (NET-HEART Project), the objective of this article is to review all the information available on the cardiac involvement of this disease.

Malaria and the Heart: JACC State-of-the-Art Review.

As one of the tropical diseases, malaria is endemic in developing countries. Severe malaria, mainly caused by the Plasmodium falciparum parasite, can result in life-threatening complications. Traditionally, cardiac involvement has not been included as a frequent cause of morbidity and mortality. This could be due to under-reporting or underdiagnosing. Specific cardiovascular (CV) complications include electrocardiogram abnormalities, myocarditis, pericarditis, pericardial effusion, ischemic disease, and heart failure. According to the data analyzed, CV manifestations can lead to severe consequences. Possible theories related to the pathophysiological mechanisms related to CV compromise include an imbalanced pro-inflammatory cytokine response and/or erythrocyte sequestration by increased cytoadherence to endothelium. Although there is a paucity of data regarding cardiac manifestations of malaria, an algorithm for appropriate use of diagnostic tools to assess cardiac involvement has been developed in this paper. Furthermore, it is important to note that typical antimalarial treatment regimens can have fatal cardiac side-effects.

Toxoplasmosis and the Heart.

Toxoplasmosis is a common disease caused by Toxoplasma gondii, a parasite with high prevalence in tropical regions. Most infections show minimal symptoms, but immunocompromised patients tend to have a poor prognosis. Cardiovascular manifestations in toxoplasmosis are rare and reported in a limited number of patients. As part of the "Neglected Tropical Diseases and Other Infectious Diseases Affecting the Heart" (NET-Heart) project, this paper aims to systematically review all available information regarding the cardiovascular implications of toxoplasmosis. Relevant studies were identified in the MEDLINE and/or PubMed database, and 48 articles were ultimately included. This was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Cardiac compromise in toxoplasmosis mainly involves myocarditis, and complications vary widely in severity. Toxoplasmic myocarditis is challenging to diagnose, as endomyocardial biopsy is usually required. This article provides a summary of cardiac toxoplasmosis, including an original algorithm facilitating diagnosis and treatment.

Impact of the Pandemic on NonInfected Cardiometabolic Patients: A Survey in Countries of Latin America-Rationale and Design of the CorCOVID LATAM Study.

BACKGROUND: The first case of coronavirus 2019 (COVID-19) in Latin America was detected on February 26th, 2020, in Brazil. Later, in June, the World Health Organization announced that the focus of the outbreak had shifted to Latin America, where countries already had poor control of indicators of noncommunicable diseases (NCDs). Concerns about coronavirus infection led to a reduced number of visits and hospitalizations in patients with NCDs, such as cardiovascular disease, diabetes, and cancer. There is a need to determine the impact of the COVID-19 pandemic on patients who have cardiometabolic diseases but do not have clinical evidence of COVID-19 infection. METHODS: The CorCOVID LATAM is a cross-sectional survey of ambulatory cardiometabolic patients with no history or evidence of COVID-19 infection. The study will be conducted by the Interamerican Society of Cardiology. An online survey composed of 38 questions using Google Forms will be distributed to patients of 13 Latin American Spanish-speaking countries from June 15th to July 15th, 2020. Data will be analyzed by country and regions. Seven clusters of questions will be analyzed: demographics, socioeconomic and educational level, cardiometabolic profile, lifestyle and habits, body-weight perception, medical follow-up and treatments, and psychological symptoms. RESULTS: Final results will be available upon completion of the study. CONCLUSIONS: The present study will provide answers regarding the impact of the COVID-19 pandemic on noninfected cardiometabolic patients. Data on this topic are scarce, as it is an unprecedented threat, without short-term solutions.

CONTEXTE: Le premier cas de maladie à coronavirus 2019 (COVID-19) en Amérique latine a été détecté le 26 février 2020 au Brésil. En juin, l'Organisation mondiale de la Santé a annoncé que le foyer de l'épidémie s'était déplacé en Amérique latine, où le suivi des indicateurs relatifs aux maladies non transmissibles est déjà déficient. Les préoccupations relatives à l'infection par le coronavirus ont entraîné une diminution du nombre de consultations et d'hospitalisations des patients atteints d'une maladie non transmissible, comme une ma-ladie cardiovasculaire, le diabète ou un cancer. Il est donc nécessaire d'évaluer l'incidence de la pandémie de COVID-19 chez les patients atteints d'une maladie cardiométabolique ne présentant aucun signe clinique d'une infection au virus de la COVID-19. MÉTHODOLOGIE: L'étude CorCOVID LATAM est une enquête transversale menée auprès des patients ambulatoires atteints d'une maladie cardiométabolique n'ayant pas d'antécédents d'infection au virus de la COVID-19 et ne présentant aucun signe d'une telle infection. L'étude est réalisée par la Société interaméricaine de cardiologie. Du 15 juin au 15 juillet 2020, on a demandé aux patients de 13 pays hispanophones d'Amérique latine de répondre à un questionnaire en ligne de 38 questions dans Google Forms. Les données seront analysées par pays et par région. Les réponses aux questions seront examinées selon sept grands thèmes : caractéristiques démographiques, caractéristiques socioéconomiques et niveau de scolarité, profil cardiométabolique, mode de vie et habitudes, perception quant au poids corporel, suivi et traitements médicaux et symptômes psychologiques. RÉSULTATS: Les résultats seront publiés à la fin de l'étude. CONCLUSIONS: L'étude fournira des renseignements sur l'incidence de la pandémie de COVID-19 chez les patients atteints d'une maladie cardiométabolique non infectés. Les données sur cette question sont rares, puisqu'il s'agit d'une menace sans précédent, à laquelle il n'existe de surcroît pas de solution à court terme.