Cardiac resynchronization therapy for patients with cardiac sarcoidosis
Akinori Sairaku1, Yukihiko Yoshida2, Yukiko Nakano1
1Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Summary
Cardiac resynchronization therapy (CRT) in cardiac sarcoidosis patients showed limited improvement in heart function. Ventricular arrhythmias were common, suggesting CRT may not be optimal for these rare cases.
Area of Science:
- Cardiology
- Immunology
- Pathology
Background:
- Cardiac sarcoidosis is a rare condition affecting the heart.
- Cardiac resynchronization therapy (CRT) is infrequently used in these patients.
Purpose of the Study:
- To clarify the clinical features of patients with cardiac sarcoidosis who received CRT.
- To evaluate the outcomes of CRT in patients with cardiac sarcoidosis.
Main Methods:
- Retrospective review of clinical data from three cardiovascular centers.
- Inclusion criteria: patients with systolic heart failure receiving CRT.
- Identified 18 cardiac sarcoidosis patients among 202 CRT recipients.
Main Results:
- Majority female (83.3%), many upgraded from pacemakers/ICDs (72.2%).
- High incidence of ventricular arrhythmias (66.7%).
- No significant improvement in LVEF or end-systolic volume at 6 months; worsening LVEF linked to post-CRT arrhythmias (P=0.04).
Conclusions:
- Cardiac sarcoidosis patients receiving CRT exhibit poor left ventricular reverse remodeling.
- High incidence of ventricular arrhythmias observed post-CRT.
- CRT outcomes in cardiac sarcoidosis warrant further investigation.
Related Concept Videos
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
688
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
688
01:30Cardiomyopathy II: Dilated Cardiomyopathy
685
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
685
01:29Cardiomyopathy V: Interprofessional Care
556
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
556
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
586
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
586
01:21Rheumatic Heart Disease III: Medical Management
434
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
434
01:14Myocarditis III: Medical Management
274
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
274