Sex-related differences in the prognosis of patients with cardiac sarcoidosis treated with cardiac resynchronization therapy

Nakasuka, Kosuke; Ishibashi, Keiichiro; Hattori, Yusuke; Mori, Kazuki; Nakajima, Kenzaburo; Nagayama, Tomomi; Kamakura, Tsukasa; Wada, Mitsuru; Inoue, Yuko; Miyamoto, Koji; Nagase, Satoshi; Noda, Takashi; Aiba, Takeshi; Takaya, Yoichi; Isobe, Mitsuaki; Terasaki, Fumio; Ohte, Nobuyuki; Kusano, Kengo

doi:10.1016/j.hrthm.2022.02.027

Cited by 11 publications

(3 citation statements)

References 29 publications

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“…Another multicentre retrospective cohort study examined 73 patients with CS treated with cardiac resynchronisation therapy. During a median follow-up of 5.2 years, no significant sex-related difference in the incidence of heart failure death was reported; however, males were associated with a significantly higher incidence of ventricular arrhythmia events than females 22. Although these findings are consistent with our results on sex differences in the risk of ventricular arrhythmia, our study cohort was not limited to patients already treated with ICD or cardiac resynchronisation therapy, who make up only 30%–40% of the entire patient population with CS 6 23.…”

Section: Discussionmentioning

confidence: 91%

Sex differences in clinical characteristics and prognosis of patients with cardiac sarcoidosis

Iso

Maeda

Matsue

et al. 2023

Heart

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ObjectiveOwing to the paucity of data, this study aimed to investigate sex differences in clinical features and prognosis of patients with cardiac sarcoidosis (CS).MethodsThis study was a secondary analysis of the ILLUstration of the Management and prognosIs of JapaNese PATiEnts with Cardiac Sarcoidosis registry—a retrospective multicentre registry that enrolled patients with CS between 2001 and 2017. The primary outcome was potentially fatal ventricular arrhythmia events (pFVAEs)—a composite of sudden cardiac death, sustained ventricular tachycardia lasting >30 s, ventricular fibrillation or the requirement for implantable cardioverter defibrillator therapy.ResultsOf the 512 participants (mean age±SD 61.6±11.4 years), 329 (64.2%) were females. Both sexes had peak ages of 60–64 years at diagnosis. Male patients were younger and had a higher prevalence of coronary artery disease and lower left ventricular ejection fraction than female patients. During a median follow-up of 3 years (IQR 1.6–5.6), pFVAEs were observed in 99 patients, with males having a significantly higher risk than females (p=0.002). This association was retained even after adjustment for other risk factors for pFVAEs, including left ventricular ejection fraction (adjusted HR 1.80; 95% CI 1.08 to 3.01, p=0.025).ConclusionApproximately two-thirds of patients with CS were females, with a peak age of approximately 60 years at clinical diagnosis in both sexes; male patients were younger than female patients. Male patients had a significantly higher risk of pFVAEs than female patients.Trial registration numberUMIN000034974.

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Section: Discussionmentioning

confidence: 91%

Sex differences in clinical characteristics and prognosis of patients with cardiac sarcoidosis

Iso

Maeda

Matsue

et al. 2023

Heart

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“…These are single‐center, retrospective data. Patients undergoing CRT‐D implantation do not exhibit a specific disease, and some populations with better prognosis, such as women with sarcoidosis, 24 have been reported. In our study, the number of cases is small, thus bias in underlying cardiac disease and other factors may have affected the results.…”

Section: Discussionmentioning

confidence: 99%

Predictors of long‐term survival in Japanese patients with heart failure with reduced ejection fraction (HFrEF) treated with cardiac resynchronization therapy‐defibrillators (CRT‐D)

Sakaguchi,

Izumi,

Wada

et al. 2023

Pacing Clinical Electrophis

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BackgroundReports on the factors predicting long‐term survival of CRT‐D cases from Western countries are increasing, however, those from Asia including Japan are still sparse. We aimed to clarify the factors predicting long‐term survival of Japanese CRT‐D cases.MethodsWe retrospectively analyzed consecutive 133 patients who underwent CRT‐D implantation between 2006 and 2021. We compared clinical factors between patients who died within 5 years after implantation (short‐survival group: n = 31) and who had survived for more than 5 years (long‐survival group: n = 36) after implantation.ResultsMajor underlying heart diseases were dilated cardiomyopathy (45%) and ischemic heart disease (12%). There was no difference between the short‐survival group and the long‐survival group in incidence of CLBBB (32% vs. 30%), whereas CRBBB was more common in the short‐survival group (26% vs. 0%, p = .004). Mechanical dyssynchrony at implantation was more frequent in the long‐survival group (48% vs. 78%, p = .02). The incidence of response to CRT at 1 year after implantation was higher in long‐survival group (19% vs. 50%, p = .02). Multiple logistic regression analysis identified NYHA class, mechanical dyssynchrony at implantation, and response at one year as predictors of long‐term survival.ConclusionsIn Japanese CRT‐D cases, lower NHYA class, preexisting mechanical dyssynchrony, and 1‐year response to CRT predict long‐term survival.

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“…52 Females CRT recipients with CS may have fewer adverse events than their male counterparts. 53 Heart transplantation and ventricular assist device should be considered in CS patients with endstage HF despite medical and interventional therapies. Recurrence of sarcoidosis in the transplanted heart has been described and may occur in up to 5% of patients.…”

Section: Hf Managementmentioning

confidence: 99%

Diagnosis and Treatment of Cardiac Sarcoidosis

Bortoli

Birnie

2023

Circ J

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About 5% of sarcoidosis patients develop clinically manifest cardiac features. Cardiac sarcoidosis (CS) typically presents with conduction abnormalities, ventricular arrhythmias and heart failure. Its diagnosis is challenging and requires a substantial degree of clinical suspicion as well as expertise in advanced cardiac imaging. Adverse events, particularly malignant arrhythmias and development of heart failure, are common among CS patients. A timely diagnosis is paramount to ameliorating outcomes for these patients. Despite weak evidence, immunosuppression (primarily with corticosteroids) is generally recommended in the presence of active inflammation in the myocardium. The burden of malignant arrhythmias remains important regardless of treatment, thus leading to the recommended use of an implantable cardioverter defibrillator in most patients with clinically manifest CS.

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Sex-related differences in the prognosis of patients with cardiac sarcoidosis treated with cardiac resynchronization therapy

Cited by 11 publications

References 29 publications

Sex differences in clinical characteristics and prognosis of patients with cardiac sarcoidosis

Sex differences in clinical characteristics and prognosis of patients with cardiac sarcoidosis

Predictors of long‐term survival in Japanese patients with heart failure with reduced ejection fraction (HFrEF) treated with cardiac resynchronization therapy‐defibrillators (CRT‐D)

Diagnosis and Treatment of Cardiac Sarcoidosis

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