Sarcoidosis-Related Cardiomyopathy: Current Knowledge, Challenges, and Future Perspectives State-of-the-Art Review

Area of Science:

• Cardiology
• Immunology
• Pathology

Background:

• Sarcoidosis-related cardiomyopathy (CS) prevalence is rising, affecting cardiac function via granulomatous infiltration.
• CS can manifest as conduction disease, arrhythmia, or heart failure, mimicking other cardiomyopathies.
• Accurate diagnosis of CS is challenging, requiring awareness and differentiation from similar conditions.

Purpose of the Study:

• To highlight the diagnostic challenges of cardiac sarcoidosis.
• To underscore the importance of an interdisciplinary approach in CS patient care and research.
• To emphasize current therapeutic strategies and knowledge gaps in CS management.

Main Methods:

• Review of clinical manifestations, extracardiac involvement, histopathology, and advanced cardiac imaging for CS diagnosis.
• Discussion of current therapeutic mainstays, primarily immunosuppression.
• Consideration of advanced therapies like ventricular assist devices and heart transplantation for end-stage disease.

Main Results:

• Diagnosis of CS requires high clinical suspicion and exclusion of other cardiac conditions.
• Immunosuppression is the primary treatment, though evidence from prospective trials is lacking.
• Disease progression can lead to advanced heart failure and ventricular arrhythmias.

Conclusions:

• Cardiac sarcoidosis presents diagnostic complexities requiring careful evaluation.
• Interdisciplinary collaboration is essential for improving patient outcomes and advancing research in CS.
• Further investigation is needed to refine understanding and therapeutic strategies for CS.