Related Experiment Video

Updated: Aug 28, 2025

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
06:59

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Published on: August 26, 2025

36

Controversies in the Treatment of Cardiac Sarcoidosis

Ogugua Ndili Obi1, Elyse E Lower2, Robert P Baughman2

  • 1Division of Pulmonary Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States.

Sarcoidosis, Vasculitis, and Diffuse Lung Diseases : Official Journal of WASOG
|September 19, 2022
PubMed

Insights

Managing cardiac sarcoidosis (CS) with immunosuppressive therapy (IST) presents challenges in treatment initiation and drug selection. Evidence is limited, with corticosteroids as first-line, but early steroid-sparing agents may improve outcomes.

Area of Science:

  • Cardiology
  • Immunology
  • Pulmonology

Background:

  • Cardiac sarcoidosis (CS) management is complex, lacking clear guidelines for treatment initiation and drug choice.
  • Corticosteroids are the primary immunosuppressive therapy (IST) for CS.
  • Limited high-quality evidence, such as randomized controlled trials, exists to guide CS treatment strategies.

Purpose of the Study:

  • To review the challenges and current understanding of immunosuppressive therapy (IST) for cardiac sarcoidosis (CS).
  • To discuss the role of corticosteroids and steroid-sparing agents in CS management.
  • To address the controversial use of anti-tumor necrosis factor (anti-TNF) agents in CS.

Main Methods:

  • Review of European Respiratory Society (ERS) clinical practice guidelines for sarcoidosis treatment.
  • Analysis of existing data on the efficacy of corticosteroids and early steroid-sparing agents.
  • Discussion of the controversial role of anti-tumor necrosis factor (anti-TNF) agents in refractory CS.

Main Results:

  • ERS guidelines strongly recommend IST for CS patients with cardiac abnormalities at risk of adverse outcomes.
  • Corticosteroids are first-line, but early initiation of steroid-sparing agents may be beneficial.
  • The use of anti-tumor necrosis factor (anti-TNF) agents in CS remains controversial.

Conclusions:

  • Effective management of cardiac sarcoidosis requires careful consideration of IST, balancing benefits and risks.
  • Further research is needed to establish optimal treatment protocols, including the role of advanced therapies like anti-TNF agents.
  • Personalized treatment strategies are crucial for patients with cardiac sarcoidosis.

Keywords:
anti-TNF agents in cardiac sarcoidosiscardiac sarcoidosiscorticosteroidsimmunosuppressive therapy

More Related Videos

Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding10:39

Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding

Published on: August 30, 2024

762
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease04:44

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Published on: June 16, 2020

20.1K

Related Concept Videos

Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

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...
21
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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...
29
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

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...
13
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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...
37
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
22
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
27