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Updated: Jan 9, 2026

Isolation and Characterization of Cardiac Mesenchymal Stromal Cells from Endomyocardial Bioptic Samples of Arrhythmogenic Cardiomyopathy Patients
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Cardiac sarcoidosis: the cardiomyopathy of a thousand faces-a narrative review

George Michas1, Efstathia Prappa1, Ioannis Liatakis1

  • 1Department of Cardiology, Evangelismos General Hospital of Athens, Athens, Greece.

Hellenic Journal of Cardiology : HJC = Hellenike Kardiologike Epitheorese
|December 3, 2025
PubMed

Insights

Cardiac sarcoidosis (CS) diagnosis is evolving, with advanced imaging now central. Multidisciplinary care and immunomodulation improve outcomes, but further research is needed for optimal management.

Area of Science:

  • Cardiology
  • Immunology
  • Medical Imaging

Background:

  • Cardiac sarcoidosis (CS) is a challenging inflammatory cardiomyopathy due to granulomatous inflammation.
  • Diagnosis is complicated by variable presentations and lack of definitive tests, leading to significant morbidity and mortality.
  • CS contributes to conduction abnormalities, arrhythmias, heart failure (HF), and sudden cardiac death (SCD).

Purpose of the Study:

  • To synthesize current knowledge on the epidemiology, pathophysiology, diagnosis, and management of CS.
  • To highlight recent advancements in diagnostic and therapeutic strategies for CS.

Main Methods:

  • A non-systematic literature search was conducted across major databases (PubMed/MEDLINE, Embase, Google Scholar).
  • Included English-language articles published from January 2010 to May 2025, encompassing original research, reviews, meta-analyses, and guidelines.

Main Results:

  • Advanced cardiac imaging, including cardiac magnetic resonance (CMR) and FDG-PET, is now pivotal in CS diagnosis.
  • Extracardiac biopsy is preferred for histological confirmation, with cardiac involvement assessed via clinical and imaging criteria.
  • Immunomodulation (corticosteroids) remains primary, supplemented by steroid-sparing agents and biologics; device therapy and guideline-directed HF management are crucial.

Conclusions:

  • International consensus stresses advanced imaging and multidisciplinary teams for CS diagnosis and management.
  • While current therapies improve outcomes, gaps remain in optimal treatment strategies.
  • Future research should focus on refining diagnostic algorithms, identifying biomarkers, and developing novel therapeutics for CS.
Abstract

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