Sarcoidosis and the heart: A review of the literature

İpek, Emrah; Demirelli, Selami; Ermis, Emrah; İnci, Sinan

doi:10.5582/irdr.2015.01023

Cited by 41 publications

(48 citation statements)

References 123 publications

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“…For instance, an increase in oxygen demand caused by tachycardia can also lead to decreased perfusion, thus elevating the cardiac troponins [198]. A similar increase can be witnessed in infiltrative cardiomyopathies such as cardiac sarcoidosis [199]. A broad number of non-cardiac events can also lead to troponin elevation, including chronic renal failure [200], cerebrovascular accidents [201] but also strenuous endurance training [202].…”

Section: Mirnas In Cardiovascular Diseasementioning

confidence: 99%

miRNAs as Biomarkers in Disease: Latest Findings Regarding Their Role in Diagnosis and Prognosis

Condrat

Thompson

Barbu

et al. 2020

Cells

767

583

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MicroRNAs (miRNAs) represent a class of small, non-coding RNAs with the main roles of regulating mRNA through its degradation and adjusting protein levels. In recent years, extraordinary progress has been made in terms of identifying the origin and exact functions of miRNA, focusing on their potential use in both the research and the clinical field. This review aims at improving the current understanding of these molecules and their applicability in the medical field. A thorough analysis of the literature consulting resources available in online databases such as NCBI, PubMed, Medline, ScienceDirect, and UpToDate was performed. There is promising evidence that in spite of the lack of standardized protocols regarding the use of miRNAs in current clinical practice, they constitute a reliable tool for future use. These molecules meet most of the required criteria for being an ideal biomarker, such as accessibility, high specificity, and sensitivity. Despite present limitations, miRNAs as biomarkers for various conditions remain an impressive research field. As current techniques evolve, we anticipate that miRNAs will become a routine approach in the development of personalized patient profiles, thus permitting more specific therapeutic interventions.Biogenesis of miRNA begins in the nucleus, where the transcription of its precursor, primary miRNA or pri-miRNA takes place under the influence of RNA polymerases II and III [11,12]. The resulting molecule is a hairpin-like structure, which contains a loop at one end [11]. This primordial mi-RNA precursor that is usually made up of hundreds of nucleotides is then processed consecutively by two RNase III enzymes [13][14][15]. The first enzyme to act upon the pri-miRNA, which still resides in the nucleus, is called Drosha or DCGR8, and turns it into a new hairpin-like structure of approximately 70 nucleotides, the Precursor-miRNA or pre-miRNA. The latter is then transported to the cytoplasm, with the help of Exportin-5, where it is cleaved again by the Ago2/Dicer complex leading to the short, mature miRNA double strands [16].Further on, one of the strands, usually known as the guide strand, will be integrated into the RNA-induced silencing complex (RISC), while the other one, known as the passenger strand, is going to be degraded, even though in some occasions it has been found to be also functional [17]. In most cases, the strand that contains the less stable 5 end or a uracil at the beginning is more likely to be selected as the guide strand [18][19][20]. In those situations, where the passenger strand is not degraded and both get incorporated into the miRISC complex, the mature miRNA in the guide strand will be the dominant one [21,22].The main role of miRNA in the human body is gene regulation [23] by mediating the degradation of mRNA and also by regulating transcription and translation through canonical and non-canonical mechanisms [4]. The canonical mechanism means that the miRISC complex containing the miRNA guide strand is exerting its action by binding to the targ...

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Section: Mirnas In Cardiovascular Diseasementioning

confidence: 99%

miRNAs as Biomarkers in Disease: Latest Findings Regarding Their Role in Diagnosis and Prognosis

Condrat

Thompson

Barbu

et al. 2020

Cells

767

583

View full text Add to dashboard Cite

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“…PH was found to have a prevalence of 73.8% in advanced sarcoidosis and is a predictor of poor prognosis 1 19. In a previous Japanese study, PH was found to be present in 5.7% of cases of CS 1 20. In another study, sarcoidosis-related PH was found to be approximately 12% by Doppler echocardiography 21.…”

Section: Discussionmentioning

confidence: 95%

“…In another study, sarcoidosis-related PH was found to be approximately 12% by Doppler echocardiography 21. PH can be the result of decreased output due to poor left ventricular function or it can be seen in patients with PS with hypoxic vasoconstriction 1 2. PH can also be caused by compression of the pulmonary vessels because of infiltration of intima and media by non-caseating granuloma and enlarged mediastinal lymph nodes 1 22.…”

Section: Discussionmentioning

confidence: 98%

“…About 14% of patients with pulmonary sarcoidosis (PS) without known cardiac involvement had diastolic dysfunction 1 7. A reversed E/A Doppler ratio together with a prolonged isovolumic relaxation time (IVRT) is among the most common echocardiographic patterns of diastolic dysfunction seen in early cardiac sarcoidosis (CS) 1 7.…”

Section: Introductionmentioning

confidence: 99%

“…Either overt or obscured, cardiac involvement in sarcoidosis is associated with poor prognosis 1. The regular monitoring of patients with PS in terms of cardiac symptoms, ECG, and echocardiography, and prompt initiation of anti-inflammatory therapy is crucial because of the increased risk of sudden death 1.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Right Ventricular Systolic and Diastolic Parameters in Pulmonary Sarcoidosis

İpek

Demirelli

Ermis

et al. 2016

Journal of Investigative Medicine

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The clinical manifestations of cardiac involvement are seen in about 5% of patients with sarcoidosis; however, the incidence of cardiac involvement is higher in the autopsy series. About 14% of patients with pulmonary sarcoidosis (PS) without known cardiac involvement had diastolic dysfunction.We aimed to determine the role of parameters of right ventricular (RV) systolic and diastolic function in patients with PS without evidence of cardiac symptoms. Our study population consisted of 28 patients with grades 1-4 PS and 24 healthy subjects. This study was a clinical prospective cohort study. RV end-diastolic area was found to be significantly higher in the PS group (p=0.032). RV fractional area change (RVFAC) and tricuspid annular plane systolic excursion (TAPSE) were shown to be statistically lower in the PS group as compared to the control group (p<0.001). However, pulmonary arterial systolic pressure was significantly higher in the PS group (p=0.003). The tricuspid E velocity and E/A ratio were found to be significantly lower in the PS group (p=0.025 and 0.009, respectively), while the tricuspid A velocity and myocardial performance index (MPI) were found to be significantly lower in the control group (p=0.034 and 0.007, respectively). Early detection of cardiac involvement in PS is crucial because of the increased morbidity and risk of sudden cardiac death. RV diastolic Doppler parameters, tissue Doppler MPI, RVFAC and TAPSE are practical and cheap techniques in the diagnosis of cardiac involvement in patients with PS. A thorough transthorasic echocardiographic examination including RV systolic and diastolic functions and tissue Doppler MPI should constitute the mainstay of initial management and follow-up in PS.

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