Risk and predictors of sudden death in cardiac sarcoidosis: A systematic review and meta-analysis

Franke, Kyle B.; Marshall, Henry; Kennewell, P.; Pham, Huy-Dat; Tully, Phillip J.; Rattanakosit, T; Mahadevan, Gnanadevan; Mahajan, Rajiv

doi:10.1016/j.ijcard.2020.11.044

Cited by 21 publications

(27 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 It also reduces the risk of arrhythmic SCD which is highest in patients with LGE on MRI, history of sustained ventricular arrhythmia, inducible ventricular arrhythmias during electrophysiological studies (EPS), and left ventricular dysfunction. 41,42 Current guidelines therefore recommend ICD implantation in CS patients with sustained VT, post cardiac arrest, and LVEF of 35% or less. Patients with LVEF >35% who have had syncope, evidence of myocardial scar on cardiac MRI or PET scan, indication for permanent pacing, and/or inducible ventricular arrhythmias during EPS are candidates for ICD implantation.…”

Section: Discussionmentioning

confidence: 99%

Cardiac sarcoidosis: Two case reports

Afriyie-Mensah

Awindaogo

Tagoe

et al. 2021

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiac sarcoidosis: Two case reports

Afriyie-Mensah

Awindaogo

Tagoe

et al. 2021

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

“…LGE-MRI and PET were associated with an 8.60 and 9.07 fold increased risk of VA, respectively, and a 6.82 and 3.41 fold increased risk of major ACE, respectively [164].…”

Section: Cardiac Mri (Cmr)mentioning

confidence: 90%

“…Patients relocated to CS had less HF at presentation (20% vs 46%, p < 0.017) and better one-year transplant-free survival compared to GCM (82% vs 45%, p = 0.011) [163]. A recent meta-analysis reviewed 19 publications up until 2020 regarding the risk of ACE and SCD in patients with symptomatic CS [164]. Positive…”

Section: Cardiac Mri (Cmr)mentioning

confidence: 99%

“…One patient was referred for heart transplant [191]. Dutch investigators recently performed a meta-analysis comprising 1,247 cases of CS over a period of 1.7 to 7 years and found that nine of 664 patients (1.36%) with confi rmed CS without ICDs died suddenly [164]. Positive LGE-CMR and (+) Programmed Electric Stimulation (PES) were associated with a relative risk (RR) of 8.6 and 9.1 increased risk of VA, respectively.…”

Section: Is There a Role For Routine Screening For Cardiac Sarcoidosis?mentioning

confidence: 99%

See 1 more Smart Citation

Cardiac involvement in sarcoidosis: Evolving concepts in diagnosis and treatment

P¹,

C²,

S³

et al. 2021

J Cardiovasc Med Cardiol

View full text Add to dashboard Cite

Clinically evident cardiac involvement has been noted in at least 2 to 7% of patients with sarcoidosis, but occult involvement is much higher (> 20%). Cardiac Sarcoidosis (CS) is often not recognized as an antemortem, as sudden death may be the presenting feature. Cardiac involvement may occur at any point during the course of sarcoidosis and may occur in the absence of pulmonary or systemic involvement. Sarcoidosis can involve any part of the heart. The prognosis of CS is related to the extent and site(s) of involvement. Most deaths due to CS are due to arrhythmias or conduction defects, but granulomatous infiltration of the myocardium may cause progressive and ultimately lethal cardiomyopathy. The definitive diagnosis of isolated CS is difficult and the yield of Endomyocardial Biopsies (EMB) is low. Treatment of CS is often warranted even in the absence of histologic proof. Radionuclide scans are integral to the diagnosis. Gadolinium-enhanced cardiac magnetic imaging scans and 18Fluorodeoxyglucose (18FDG)-Positron Emission Tomography (PET) are the key imaging modalities to diagnose CS. The prognosis of CS is variable, but mortality rates of untreated CS are high. Randomized therapeutic trials have not been done, but corticosteroids (alone or combined with additional immunosuppressive agents) are the mainstay of therapy. Additionally, anti-arrhythmic agents and therapy for heart failure are often required. Because of the potential for sudden cardiac death, an Implantable Cardioverter-Defibrillator (ICD) should be placed in any patient with CS and serious ventricular arrhythmias or heart block and should be considered for cardiomyopathy. Cardiac transplantation is a viable option for patients with end-stage CS refractory to medical therapy.

show abstract

“…Modest improvement has also been achieved by visualizing active inflammation on 18 F-fludeoxyglucose (FDG) positron emission tomography (PET) scans (7). Despite these efforts, a recent meta-analysis found that the level of appropriate ICD therapy in CS is only 22 to 36%, while 11 to 25% of patients receive inappropriate therapy (8).…”

Section: Introductionmentioning

confidence: 99%

Predicting risk of sudden cardiac death in patients with cardiac sarcoidosis using multimodality imaging and personalized heart modeling in a multivariable classifier

et al. 2021

View full text Add to dashboard Cite

Cardiac sarcoidosis (CS), an inflammatory disease characterized by formation of granulomas in the heart, is associated with high risk of sudden cardiac death (SCD) from ventricular arrhythmias. Current “one-size-fits-all” guidelines for SCD risk assessment in CS result in insufficient appropriate primary prevention. Here, we present a two-step precision risk prediction technology for patients with CS. First, a patient’s arrhythmogenic propensity arising from heterogeneous CS-induced ventricular remodeling is assessed using a novel personalized magnetic-resonance imaging and positron-emission tomography fusion mechanistic model. The resulting simulations of arrhythmogenesis are fed, together with a set of imaging and clinical biomarkers, into a supervised classifier. In a retrospective study of 45 patients, the technology achieved testing results of 60% sensitivity [95% confidence interval (CI): 57-63%], 72% specificity [95% CI: 70-74%], and 0.754 area under the receiver operating characteristic curve [95% CI: 0.710-0.797]. It outperformed clinical metrics, highlighting its potential to transform CS risk stratification.

show abstract

Risk and predictors of sudden death in cardiac sarcoidosis: A systematic review and meta-analysis

Cited by 21 publications

References 41 publications

Cardiac sarcoidosis: Two case reports

Cardiac sarcoidosis: Two case reports

Cardiac involvement in sarcoidosis: Evolving concepts in diagnosis and treatment

Predicting risk of sudden cardiac death in patients with cardiac sarcoidosis using multimodality imaging and personalized heart modeling in a multivariable classifier

Contact Info

Product

Resources

About