Cardiac Sarcoidosis

Kadosh, Bernard; Steele, Jeremy; Gulkarov, Iosif; Mamkin, Igor

doi:10.1016/j.jacc.2012.09.074

Cited by 5 publications

(4 citation statements)

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“…It is associated with restrictive cardiomyopathy in 5% of patients, but may later progress to DCM [102] . It is difficult to diagnose unless there is other organ involvement (usually pulmonary).…”

Section: Sarcoidosismentioning

confidence: 99%

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Sisakian¹

2014

WJC

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Cardiomyopathies are defined as diseases of the myocardium with associated structural and functional abnormalities. Knowledge of these pathologies for a long period was not clear in clinical practice due to uncertainties regarding definition, classification and clinical diagnosis. In recent decades, major advances have been made in the understanding of the molecular and genetic issues, pathophysiology, and clinical and radiological assessment of the diseases. Progress has been made also in management of several types of cardiomyopathy. Advances in the understanding of these diseases show that cardiomyopathies represent complex entities. Here, special attention is given to evolution of classification of cardiomyopathies, with the aim of assisting clinicians to look beyond schematic diagnostic labels in order to achieve more specific diagnosis. Knowledge of the genotype of cardiomyopathies has changed the pathophysiological understanding of their etiology and clinical course, and has become more important in clinical practice for diagnosis and prevention of cardiomyopathies. New approaches for clinical and prognostic assessment are provided based on contemporary molecular mechanisms of contribution in the pathogenesis of cardiomyopathies. The genotype-phenotype complex approach for assessment improves the clinical evaluation and management strategies of these pathologies. The review covers also the important role of imaging methods, particularly echocardiography, and cardiac magnetic resonance imaging in the evaluation of different types of cardiomyopathies. In summary, this review provides complex presentation of current state of cardiomyopathies from genetics to management aspects for cardiovascular specialists.

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Section: Sarcoidosismentioning

confidence: 99%

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Sisakian¹

2014

WJC

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“…The poor prognosis of sarcoidosis patients with cardiac involvement is well documented [ 1 , 20 , 21 ]. Immunosuppressive therapy, in particular using high-dose corticosteroids, is necessary to prevent malignant arrhythmias and progressive heart failure [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 42 (39%) of the 108 patients endomyocardial biopsies (EMB) were available; 31 patients were virus positive with predominance of erythorvirus (20), other viruses were HHV6 (6) and Epstein-Barr (EBV) (1). One patient with giant cell myocarditis was detected.…”

Section: Basic Characteristicsmentioning

confidence: 99%

Regional extracellular volume within late gadolinium enhancement-positive myocardium to differentiate cardiac sarcoidosis from myocarditis of other etiology: a cardiovascular magnetic resonance study

Vietheer

Novak

Fischer‐Rasokat

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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Background Cardiovascular magnetic resonance (CMR) plays a pivotal role in diagnosing myocardial inflammation. In addition to late gadolinium enhancement (LGE), native T1 and T2 mapping as well as extracellular volume (ECV) are essential tools for tissue characterization. However, the differentiation of cardiac sarcoidosis (CS) from myocarditis of other etiology can be challenging. Positron-emission tomography-computed tomography (PET-CT) regularly shows the highest Fluordesoxyglucose (FDG) uptake in LGE positive regions. It was therefore the aim of this study to investigate, whether native T1, T2, and ECV measurements within LGE regions can improve the differentiation of CS and myocarditis compared with using global native T1, T2, and ECV values alone. Methods PET/CT confirmed CS patients and myocarditis patients (both acute and chronic) from a prospective registry were compared with respect to regional native T1, T2, and ECV. Acute and chronic myocarditis were defined based on the 2013 European Society of Cardiology position paper on myocarditis. All parametric measures and ECV were acquired in standard fashion on three short-axis slices according to the ConSept study for global values and within PET-CT positive regions of LGE. Results Between 2017 and 2020, 33 patients with CS and 73 chronic and 35 acute myocarditis patients were identified. The mean ECV (± SD) in LGE regions of CS patients was higher than in myocarditis patients (CS vs. acute and chronic, respectively: 0.65 ± 0.12 vs. 0.45 ± 0.13 and 0.47 ± 0.1; p < 0.001). Acute and chronic myocarditis patients had higher global native T1 values (1157 ± 54 ms vs. 1196 ± 63 ms vs. 1215 ± 74 ms; p = 0.001). There was no difference in global T2 and ECV values between CS and acute or chronic myocarditis patients. Conclusion This is the first study to show that the calculation of regional ECV within LGE-positive regions may help to differentiate CS from myocarditis. Further studies are warranted to corroborate these findings.

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“…Sarcoidosis is a systemic disease resulting in the formation of noncaseating granulomas that can infiltrate the myocardium. It is associated with restrictive cardiomyopathy in 5% of patients, but may later progress to DCM [102] . It is difficult to diagnose unless there is other organ involvement (usually pulmonary).…”

Section: Sarcoidosismentioning

confidence: 99%

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Sisakian¹

2014

WJC

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Core tip: Cardiomyopathies represent a different group of disorders in which myocardium is itself structurally and functionally abnormal. During recent decades, the genetics, pathophysiology and diagnosis of cardiomypathy have advanced from the traditional methods of clinical presentation to new genetic and imaging techniques. Nevertheless, the differences in definition, classification, pathophysiological mechanisms and diagnosis are controversial issues in clinical practice. The purpose of this review is to present the current state of classification, genetics, diagnostic approaches and management in order to provide useful instructions for clinical practice. Sisakian H. Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies.

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Cardiac Sarcoidosis

Cited by 5 publications

References 0 publications

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Regional extracellular volume within late gadolinium enhancement-positive myocardium to differentiate cardiac sarcoidosis from myocarditis of other etiology: a cardiovascular magnetic resonance study

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

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