Cardiac Sarcoidosis

Abstract

This retrospective study concerned 18 female and 23 male patients with cardiac sarcoidosis (CS). The average age at CS diagnosis was 38 years. CS was observed in white (73% of cases) and in black or Caribbean patients (27% of cases). All patients had extracardiac histologic proof of sarcoid tissue. In 63% of cases, the CS arose during the follow-up of systemic sarcoidosis. Systemic sarcoidosis was not specific except for a high frequency of neurosarcoidosis. Revealing cardiac signs were clinical in 63% of cases and electrical in 22%. In most patients these signs were associated with an abnormal echocardiography (77%) and/or a defect on thallium-201 or sestamibi imaging (75%). Thirty-nine patients received steroid therapy (initial dose mostly equal to 1 mg/kg per day), associated in 13 cases with another immunosuppressive treatment. In 26% of cases the immunosuppressive treatment was associated with a specific cardiac treatment. In the long-term follow-up (average follow-up, 58 mo), 87% of the cases showed an improvement, and 54% were cured from a clinical and laboratory point of view (electrocardiogram, 24-hour monitoring, echocardiography, radionuclide imaging). There was no sudden death. Two patients worsened, which can be explained in 1 case by very late treatment and in the other case by lack of treatment, except for a pacemaker. Our experience leads us to treat CS with corticosteroids as soon as possible and to use another immunosuppressive treatment where there is an insufficient therapeutic response or where there are contraindications to corticosteroids.

Steroid pulse therapy was effective for cardiac sarcoidosis with ventricular tachycardia and systolic dysfunction

“…Small‐sized retrospective studies showed that steroid improved nearly 50% of cardiac sarcoidosis patients with complete AV block 2, 3. Chapelon‐Abric et al demonstrated that clinical response to prednisolone was limited to the early stage of cardiac sarcoidosis 6. In addition, other studies suggested that steroid was less effective in cardiac sarcoidosis patients with severe left ventricular dysfunction 7…”

Effect of Corticosteroid Therapy on Long-Term Clinical Outcome and Left Ventricular Function in Patients With Cardiac Sarcoidosis

“…15 ChapelonAbric et al also reported that 87% of CS patients who received corticosteroid therapy had clinical improvement, although the study population was relatively small. 5 Furthermore, several case reports have documented the effectiveness of corticosteroid therapy for improving LV function, atrial arrhythmias, advanced AV block, and electrocardiographic abnormalities in CS patients, even in those with severe myocardial damage. 8-12, 18 The present study examined clinical outcomes of CS patients for a longer follow-up period and grouped patients into treated and untreated groups at the diagnosis of CS, rather than identifying untreated patients on post-mortem diagnosis.…”

Implantable Cardioverter Defibrillator Therapy in Patients with Cardiac Sarcoidosis

“…1 Cardiac involvement is diagnosed antemortem in approximately 5% of systemic sarcoidosis patients but is seen in up to 25% of patients with systemic sarcoidosis on autopsy. 2 The leading causes of death in patients with sarcoidosis are cardiac arrhythmias, progressive heart failure, and progressive respiratory failure.…”