Cardiac sarcoidosis: A long term follow up study
Patrice Cacoub1,2,3,4, Catherine Chapelon-Abric1,4, Matthieu Resche-Rigon5,6,7
1UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, Paris, France.
Plos One
|September 18, 2020
Summary
Prognostic factors for cardiac sarcoidosis (CS) include heart block, low ejection fraction, and hypertension. Intravenous cyclophosphamide treatment may reduce cardiac relapse risk in CS patients.
Area of Science:
- Cardiology
- Immunology
- Pulmonology
Background:
- Cardiac sarcoidosis (CS) lacks established prognostic factors.
- The impact of immunosuppressive therapies on CS outcomes remains unclear.
Purpose of the Study:
- Identify prognostic factors for mortality and relapse in CS.
- Evaluate the effectiveness of immunosuppressive drugs in reducing relapse risk.
Main Methods:
- Analysis of a 157-patient cohort with CS and a 7-year median follow-up.
- Assessment of cardiac and extra-cardiac data, treatments, and survival outcomes.
- Statistical analysis including hazard ratios for mortality and relapse.
Main Results:
- 10-year survival rate was 90%. Key mortality predictors included high-degree AV block, LVEF < 40%, hypertension, abnormal PFTs, and LGE on CMR.
- 10-year relapse-free survival was 53%. Independent predictors of cardiac relapse were kidney involvement, wall motion abnormalities, and left heart failure.
- Intravenous cyclophosphamide was associated with a significantly lower risk of cardiac relapse.
Conclusions:
- Identified key prognostic factors for morbidity and mortality in cardiac sarcoidosis.
- Intravenous cyclophosphamide demonstrates potential in reducing cardiac relapse rates in CS patients.
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