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Cardiac Involvement in Neurosarcoidosis: A Single-Center Investigation

Sama Noroozi Gilandehi¹, Ka-Ho Wong¹, Trieste Francis¹

¹From the Department of Neurology (S.N.G., K.-H.W., T.F., M.A.W., J.L., T.S., S.L.C.); Division of Cardiovascular Medicine (J.S., L.K.), Department of Internal Medicine, University of Utah; Department of Neurology (J.S., L.K., T.S., S.L.C.); Geriatric Research Education and Clinical Center (T.S.), George E. Whalen Department of Veterans Affairs Medical Center; and Department of Pathology (T.S.), University of Utah, Salt Lake City.

Neurology(R) Neuroimmunology & Neuroinflammation

|January 5, 2024

Summary

Cardiac sarcoidosis (CS) affects 12% of patients with neurosarcoidosis (NS). These patients also face other cardiovascular issues, highlighting the need for thorough cardiac screening in NS cases.

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Area of Science:

Cardiology
Neurology
Immunology

Background:

Sarcoidosis is a multisystem inflammatory disease.
Cardiac and nervous system involvement significantly increases morbidity and mortality.
Cardiac sarcoidosis (CS) and neurosarcoidosis (NS) can co-occur.

Purpose of the Study:

To determine the incidence of CS in a neurosarcoidosis cohort.
To assess the frequency of non-sarcoid cardiac diseases in patients with NS.

Main Methods:

Retrospective chart review of patients evaluated at the University of Utah (2010-2022).
Inclusion criteria: sarcoidosis diagnosis (ICD-9 135, ICD-10 D86), definite/probable/possible NS diagnosis, cardiology and neurology outpatient visits, and available ECG.
52 patients with NS met the inclusion criteria.

Main Results:

12% (6 of 52) of patients with NS were diagnosed with CS.
Common symptoms included lower extremity edema (50%), palpitations (46%), chest pain (44%), and shortness of breath (27%).
ECG abnormalities were frequent, and cardiac MRI revealed diffuse myocardial enhancement in some patients suggesting CS.

Conclusions:

A significant proportion of NS patients have co-existing CS.
Patients with NS exhibit a high burden of cardiovascular disease, some not directly linked to sarcoidosis.
Comprehensive cardiac evaluation is essential for patients diagnosed with neurosarcoidosis.