Fatal Arrhythmic Risks in Cardiac Sarcoidosis With Mildly Impaired Cardiac Function

Area of Science:

• Cardiology
• Immunology
• Internal Medicine

Background:

• Cardiac sarcoidosis (CS) prognosis and fatal arrhythmia risk remain unclear in patients with preserved cardiac function.
• Limited data exists on arrhythmic events and long-term outcomes for CS patients with mildly impaired left ventricular ejection fraction (LVEF).

Purpose of the Study:

• To evaluate the prognosis and incidence of arrhythmic events in patients diagnosed with CS and mildly impaired cardiac function (LVEF >35%).

Main Methods:

• A nationwide Japanese cohort survey included 322 CS patients with LVEF >35% from 57 hospitals.
• Data analysis involved Kaplan-Meier survival and multivariate analyses to identify predictors of ventricular arrhythmic events (VAEs).

Main Results:

• All-cause mortality did not differ between patients with and without ventricular tachycardia (VT) manifestation (P = 0.660).
• Appropriate implantable cardioverter-defibrillator (ICD) therapy was significantly less frequent in patients without VT (P < 0.001).
• Independent predictors for VAEs included nonsustained VT with atrioventricular block, lower LVEF, and abnormal gallium-67 scintigraphy or 18F-fluorodeoxyglucose positron emission tomography (Ga/PET).

Conclusions:

• In CS patients with LVEF >35%, implantable cardioverter-defibrillator (ICD) consideration for primary prevention is warranted if nonsustained VT with atrioventricular block, nonsustained VT with abnormal Ga/PET, or abnormal Ga/PET is present.