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What cardiologists should know about cardiac sarcoidosis in 2022?

Sylvain Lemay1, Laurie Marchand, Mario Sénéchal

  • 1Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Quebec, Canada.

Current Opinion in Cardiology
|June 22, 2022
PubMed
Abstract

Insights

Cardiac sarcoidosis (CS) requires timely diagnosis and treatment. New strategies improve recognition, while updated immunosuppressive therapies, including corticosteroid-sparing agents, are crucial for refractory cases.

Area of Science:

  • Cardiology
  • Immunology
  • Pathology

Background:

  • Cardiac sarcoidosis (CS) is a serious condition with increasing diagnoses.
  • Imaging lacks specificity but aids biopsy in CS diagnosis.
  • A significant portion of patients are refractory to standard prednisone treatment.

Purpose of the Study:

  • To present novel strategies for enhancing clinical recognition of CS.
  • To offer an updated review of immunosuppressive treatments for CS.
  • To incorporate the latest data from the past 18 months.

Main Methods:

  • Review of recent literature on CS diagnosis and treatment.
  • Analysis of imaging's role in diagnostic yield.
  • Evaluation of current immunosuppressive regimens and outcomes.

Main Results:

  • CS diagnostic rates have risen significantly.
  • Imaging supports biopsy but lacks standalone specificity.
  • Approximately 25% of CS patients do not respond to prednisone alone.
  • Combined therapies with corticosteroid-sparing agents are often necessary.

Conclusions:

  • Histological confirmation via biopsy is essential before initiating immunosuppressive therapy for CS.
  • Corticosteroids, potentially with corticosteroid-sparing agents, form the cornerstone of CS treatment.
  • Long-term treatment duration for CS remains to be determined.

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