Serial Measurement of High-Sensitivity Cardiac Troponin I and N-Terminal proB-Type Natriuretic Peptide in a Patient Presenting with Cardiac Sarcoidosis

Tanada, Yohei; Sato, Yukihito; Sawa, Takuma; Fujiwara, Hisayoshi; Tokura, Y.

doi:10.2169/internalmedicine.51.8334

Cited by 9 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 40 , 42 Interestingly, studies show that troponin levels can predict risk of arrhythmias, and levels often decrease with improvement in cardiac function and inflammation after treatment. 43 , 44 , 45 Elevated BNP levels also have been reported as a marker of cardiac involvement in patients with extracardiac sarcoidosis. 45 Markers of inflammation, including serum levels of soluble IL-2 receptors, neopterin and cytokines such as IL-1α, IL-2, IL-12 p40, and IFN-γ have been evaluated as markers of disease activity in small studies although sensitivity and specificity have been poor.…”

Section: Basic Cardiac Evaluationmentioning

confidence: 99%

Epidemiology, Pathogenesis, and Diagnosis of Cardiac Sarcoidosis

Mathai

Patel

Jorde

et al. 2022

Methodist DeBakey Cardiovascular Journal

View full text Add to dashboard Cite

Cardiac sarcoidosis (CS) is a widely underdiagnosed yet clinically significant form of granulomatous myocarditis associated with significant morbidity and mortality. Clinical presentation ranges from silent cardiac involvement detected on imaging to cardiomyopathy or sudden cardiac death. Diagnosis of CS remains challenging due to the lack of sensitivity and specificity of any single diagnostic method, underscoring the importance of elevated clinical suspicion and the use of multimodality imaging to guide diagnosis and treatment. In this review, we discuss the epidemiology, pathogenesis, clinical features, and diagnosis of this clinically evading and enigmatic disease.

show abstract

Section: Basic Cardiac Evaluationmentioning

confidence: 99%

Epidemiology, Pathogenesis, and Diagnosis of Cardiac Sarcoidosis

Mathai

Patel

Jorde

et al. 2022

Methodist DeBakey Cardiovascular Journal

View full text Add to dashboard Cite

show abstract

“…Some evidence suggests a role for biomarkers, including troponins, brain natriuretic factor and SACE levels 37 47. High-sensitivity troponin I has been reported as a useful marker to follow the activity of cardiac sarcoidosis, and was noted to fall after steroid therapy in some patients 98 99. In practice, it is usually a combination of all available evidence that forms any assessment of treatment response.…”

Section: Managementmentioning

confidence: 99%

Cardiac sarcoidosis: diagnosis and management

Dubrey

Sharma

Underwood

et al. 2015

Postgraduate Medical Journal

View full text Add to dashboard Cite

Cardiac sarcoidosis is one of the most serious and unpredictable aspects of this disease state. Heart involvement frequently presents with arrhythmias or conduction disease, although myocardial infiltration resulting in congestive heart failure may also occur. The prognosis in cardiac sarcoidosis is highly variable, which relates to the heterogeneous nature of heart involvement and marked differences between racial groups. Electrocardiography and echocardiography often provide the first clue to the diagnosis, but advanced imaging studies using positron emission tomography and MRI, in combination with nuclear isotope perfusion scanning are now essential to the diagnosis and management of this condition. The identification of clinically occult cardiac sarcoidosis and the management of isolated and/or asymptomatic heart involvement remain both challenging and contentious. Corticosteroids remain the first treatment choice with the later substitution of immunosuppressive and steroid-sparing therapies. Heart transplantation is an unusual outcome, but when performed, the results are comparable or better than heart transplantation for other disease states. We review the epidemiology, developments in diagnostic techniques and the management of cardiac sarcoidosis.

show abstract

“… 8 Previously, elevated cardiac troponin was sometimes observed in cardiac sarcoidosis, with a decrease in these levels after the commencement of glucocorticoid therapy. 9 , 10 Another study suggested that patients with cardiac sarcoidosis depicting elevated cardiac troponin levels at presentation had a significantly lower LVEF and tended to exhibit more adverse cardiac events than those with normal cardiac troponin levels. 11 In this study, the hs-cTnI concentration decreased after glucocorticoid therapy was initiated and increased before a disease relapse that was confirmed by 18 F-FDG PET/CT, indicating that the levels of circulating cardiac troponin reflected the cardiac injury caused by cardiac sarcoidosis, and could serve as a sensitive biomarker of disease activity to optimize immunosuppressive therapy.…”

Section: Discussionmentioning

confidence: 99%

High-sensitivity cardiac troponin serving as a useful marker for the early recognition of relapse of isolated cardiac sarcoidosis: a case report

Tashiro

Tanaka

Hikita

et al. 2022

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background Isolated cardiac sarcoidosis is a relatively rare disease that is difficult to manage because of challenges in determining the progression and flare-up of cardiac lesions. Routine reduction of glucocorticoid doses may lead to treatment failure and disease relapse, which are associated with increased mortality. Case Summary Herein, we present the case of a 49-year-old woman with isolated cardiac sarcoidosis in whom high-sensitivity cardiac troponin served as a biomarker for tailoring immunosuppressive therapy. She presented with progressive dyspnoea on exertion for two months, and had elevated levels of high-sensitivity cardiac troponin I (hs-cTnI) at presentation. A diagnosis of isolated cardiac sarcoidosis was made based on the finding of electrocardiography, echocardiography, cardiac magnetic resonance imaging, and 18F-fluorodeoxyglucose (FDG) positron emission tomography. After the introduction of glucocorticoids, the hs-cTnI concentration immediately decreased, followed by disappearance of FDG uptake in the heart. However, two months after oral prednisolone was reduced to the maintenance dose, the hs-cTnI concentration began to increase gradually, and two months later, worsening heart failure, progression of impaired left ventricular function, and de novo accumulation of FDG in the heart were observed, confirming the relapse of cardiac sarcoidosis. Intensified glucocorticoid therapy resulted in an another immediate decrease in hs-cTnI concentration and improved heart failure management. Discussion This case highlights the potential of hs-cTnI to serve as a serum biomarker for monitoring disease activity and response to immunosuppressive therapy in patients with cardiac sarcoidosis. The hs-cTnI could be a highly-sensitive and cost-effective biomarker reflecting inflammatory status of cardiac sarcoidosis.

show abstract

Serial Measurement of High-Sensitivity Cardiac Troponin I and N-Terminal proB-Type Natriuretic Peptide in a Patient Presenting with Cardiac Sarcoidosis

Cited by 9 publications

References 6 publications

Epidemiology, Pathogenesis, and Diagnosis of Cardiac Sarcoidosis

Epidemiology, Pathogenesis, and Diagnosis of Cardiac Sarcoidosis

Cardiac sarcoidosis: diagnosis and management

High-sensitivity cardiac troponin serving as a useful marker for the early recognition of relapse of isolated cardiac sarcoidosis: a case report

Contact Info

Product

Resources

About