TY - JOUR
T1 - Clinical presentation, management and prognosis of patients with cardiac sarcoidosis
AU - Ghanizada, Muzhda
AU - Rossing, Kasper
AU - Bundgaard, Henning
AU - Gustafsson, Finn
N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
PY - 2018/4
Y1 - 2018/4
N2 - INTRODUCTION: The course and prognosis of cardiac sarcoidosis (CS) are sparsely described. The purpose of this study was to assess the clinical presentation, treatment response and prognosis for patients with CS. METHODS: This was a single-centre retrospective study of patients with CS from 2006 to 2016. A total of 197 patients with a sarcoidosis diagnosis were screened, and 17 patients (mean age 46.9 years, 59% men) were diagnosed with CS based on Japanese Ministry of Health and Welfare criteria; 53% were diagnosed by a positive MRI, 29% by endomyocardial biopsy. Of 17 patients, nine (53%) had a left ventricular ejection fraction (LVEF) < 45% at the time of diagnosis. The median follow-up was four years. In 13 patients, an im-plantable defibrillator was used and six of these (46%) received first appropriate shock therapy after a mean follow-up of two years. A total of 11 (65%) patients were treated with prednisolone and five (45%) of these 11 patients were also treated with another immunosuppressant. RESULTS: The median LVEF did not change at the last follow-up (p = 0.68), but improved in 30% of patients on combination therapy with prednisolone and proliferation in-hibitors, whereas 23% of patients with prednisolone monotherapy experienced further worsening of LVEF. Im-munosuppression was not used in 35% of patients. During follow-up, one patient underwent a successful heart transplant, one had a left ventricular assist device implantation and one died from septic shock. CONCLUSION: In CS patients, ventricular arrhythmias and impairment of LVEF were frequently seen, but the medium-term survival was excellent on heart failure therapy and im-munosuppression. FUNDING: none. TRIAL REGISTRATION: Danish Data Protection Agency: (File no. RH-2016-301, I-Suite no. 04965).
AB - INTRODUCTION: The course and prognosis of cardiac sarcoidosis (CS) are sparsely described. The purpose of this study was to assess the clinical presentation, treatment response and prognosis for patients with CS. METHODS: This was a single-centre retrospective study of patients with CS from 2006 to 2016. A total of 197 patients with a sarcoidosis diagnosis were screened, and 17 patients (mean age 46.9 years, 59% men) were diagnosed with CS based on Japanese Ministry of Health and Welfare criteria; 53% were diagnosed by a positive MRI, 29% by endomyocardial biopsy. Of 17 patients, nine (53%) had a left ventricular ejection fraction (LVEF) < 45% at the time of diagnosis. The median follow-up was four years. In 13 patients, an im-plantable defibrillator was used and six of these (46%) received first appropriate shock therapy after a mean follow-up of two years. A total of 11 (65%) patients were treated with prednisolone and five (45%) of these 11 patients were also treated with another immunosuppressant. RESULTS: The median LVEF did not change at the last follow-up (p = 0.68), but improved in 30% of patients on combination therapy with prednisolone and proliferation in-hibitors, whereas 23% of patients with prednisolone monotherapy experienced further worsening of LVEF. Im-munosuppression was not used in 35% of patients. During follow-up, one patient underwent a successful heart transplant, one had a left ventricular assist device implantation and one died from septic shock. CONCLUSION: In CS patients, ventricular arrhythmias and impairment of LVEF were frequently seen, but the medium-term survival was excellent on heart failure therapy and im-munosuppression. FUNDING: none. TRIAL REGISTRATION: Danish Data Protection Agency: (File no. RH-2016-301, I-Suite no. 04965).
KW - Anti-Arrhythmia Agents/therapeutic use
KW - Cardiomyopathies/complications
KW - Defibrillators, Implantable
KW - Electrocardiography
KW - Female
KW - Follow-Up Studies
KW - Heart/diagnostic imaging
KW - Heart-Assist Devices
KW - Humans
KW - Immunosuppressive Agents/therapeutic use
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Outcome Assessment (Health Care)
KW - Pacemaker, Artificial
KW - Retrospective Studies
KW - Sarcoidosis/complications
M3 - Journal article
C2 - 29619923
SN - 1603-9629
VL - 65
JO - Danish Medical Journal
JF - Danish Medical Journal
IS - 4
M1 - A5462
ER -