Health-related quality of life in cardiac sarcoidosis: a systematic review

Abstract

Aims People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. CS can result in a constellation of intrusive symptoms (such as palpitations, dizziness, syncope/presyncope, chest pain, dyspnoea, orthopnoea, or peripheral oedema) and/or life-threatening episodes, requiring consideration of invasive cardiac procedures for diagnosis and for the management of acute events. Additionally, the presence of multisystemic involvement and persistent nonspecific sarcoidosis symptoms negatively affect HRQoL. A systematic review was undertaken to explore the impact of CS on HRQoL in adults with CS. Methods and Results Multiple bibliographic databases were searched for studies with HRQoL as primary or secondary outcomes in CS (PROSPERO registration: CRD42019119752). Data extraction and quality assessments were undertaken independently by two authors. From the initial 1609 identified records, only 11 studies included CS-patients but none specifically reported HRQoL-scores for CS-patients. The average representation of CSpatients was 14.5% within these cohorts [range 2-22%]. The majority (73%) were conducted in single-centre tertiary care settings and only one study (9%) included longitudinal HRQoL data. CS-patients were among those sarcoidosis patients with impaired HRQoL and worse outcomes, requiring higher doses of sarcoidosis-specific therapy which contribute to further deterioration of HRQoL. Conclusions Sarcoidosis studies do not incorporate stratified HRQoL-scores for CSpatients. While there is a need for longitudinal and multicentre studies assessing HRQoL outcomes in CS-cohorts, the development of CS-specific tools is also needed.