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Cardiac sarcoidosis: Diagnosis, therapeutic management and prognostic factors

Catherine Chapelon-Abric1, Damien Sene2, David Saadoun1

  • 1Département de Médecine Interne et d'Immunologie Clinique, CHU Pitié-Salpétrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.

Archives of Cardiovascular Diseases
|June 2, 2017
PubMed

Insights

Cardiac sarcoidosis (CS) treatment with steroids, alone or combined with immunosuppressants, shows a good prognosis. Most patients recovered, with a 5-year survival rate of 92%.

Area of Science:

  • Cardiology
  • Immunology
  • Pulmonology

Background:

  • Cardiac sarcoidosis (CS) is a severe manifestation of sarcoidosis, often presenting in cardiology settings.
  • Despite treatment, CS poses a significant mortality risk, contributing to a substantial portion of sarcoidosis-related deaths.

Purpose of the Study:

  • To provide an overview of CS in a non-cardiac unit.
  • To analyze the impact of initial immunosuppressive therapy on CS outcomes and survival.
  • To identify factors associated with disease relapse in CS patients.

Main Methods:

  • Retrospective analysis of 59 CS patients selected from 534 sarcoidosis cases using 2006 international criteria.
  • Detailed review of symptoms, physical findings, and cardiac investigations.
  • Median follow-up duration of 60 months.

Main Results:

  • Eighty-one percent of patients had echocardiography abnormalities, 84% showed isotopic defects, and 92% had abnormal MRI findings.
  • First-line treatment involved steroids alone (24 patients) or steroids plus immunosuppressants (35 patients).
  • Overall recovery was 80%, with 5-year survival at 92%. No significant difference in recovery rates between treatment groups.

Conclusions:

  • Patients with CS treated with steroids or combined immunosuppressive therapy exhibit a favorable prognosis.
  • A 5-year survival rate of 92% and an 85% recovery rate were observed.
  • Treatment approach (steroids alone vs. combined) did not significantly impact recovery rates.
Abstract

Keywords:
Cardiac sarcoidosisCorticoïdesCyclophosphamideMethotrexateMéthotrexateRechute taux de guérisonRelapseSarcoïdose cardiaqueSteroidsSurvival rate

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