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Relapse Patterns and Clinical Outcomes in Cardiac Sarcoidosis: Insights from a Retrospective Single-Center Cohort
Arnaud Dominati1,2, Geoffrey Urbanski1,3, Philippe Meyer4
1Division of Clinical Immunology and Allergology, Department of Medicine, Geneva University Hospital, 1205 Geneva, Switzerland.
Journal of Clinical Medicine
|September 13, 2025
Summary
Relapse is common in cardiac sarcoidosis (CS), often subclinical and detected via PET-CT. Early immunosuppression tapering and right ventricular uptake predict relapse, suggesting maintenance therapy may be beneficial.
Area of Science:
- Cardiology
- Immunology
- Medical Imaging
Background:
- Cardiac sarcoidosis (CS) is a serious inflammatory heart condition with varied symptoms.
- Long-term outcomes and relapse patterns in CS patients are not well understood.
- Current imaging and immunosuppressive (IS) therapies have limitations in managing CS.
Purpose of the Study:
- To investigate relapse patterns in a real-world cardiac sarcoidosis cohort.
- To identify predictors of relapse and major adverse cardiac events (MACE) in CS patients.
- To evaluate the role of imaging and IS therapy in CS management.
Main Methods:
- Retrospective analysis of 25 adult CS patients diagnosed between 2016-2024.
- Relapse defined by clinical, arrhythmic, or imaging deterioration requiring treatment escalation.
- Statistical analysis included Kaplan-Meier and multivariable Cox regression.
Main Results:
- Relapse occurred in 56% of patients, often subclinical and detected on PET-CT.
- Predictors of relapse included right ventricular FDG uptake and short duration of second-line IS therapy.
- Patients relapse-free were more likely on dual/triple IS therapy and low-dose prednisone.
Conclusions:
- Relapse is frequent in CS, frequently asymptomatic, and linked to PET-CT findings and early IS tapering.
- Maintaining immunosuppressive therapy may lower the risk of CS relapse.
- Multimodal imaging is crucial for monitoring CS, but more specific tracers are needed.
Keywords:
cardiac sarcoidosisgranulomatous inflammationimmunosuppressive therapymajor adverse cardiac eventspositron emission tomographyrelapseMore Related Videos
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