The Prognosis of Sarcoid Heart Disease in the United Kingdom

Fleming, H A; Bailey, Sr

doi:10.1111/j.1749-6632.1986.tb18531.x

Cited by 44 publications

(35 citation statements)

References 8 publications

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“…Although these estimates are better than the earlier figures, even for 5‐year survival (40–75%),19, 20, 21 CS remains a potentially fatal disease. With current heart failure therapy, including use of mechanical support devices and heart transplantation, the overwhelming majority of deaths from CS are caused by sudden cardiac arrests.…”

Section: Discussionmentioning

confidence: 58%

“…Most of the comparable previous work11, 12, 19, 24, 25, 27 relied mainly on the Japanese diagnostic criteria,22, 23 which suffer from problems with sensitivity and specificity3, 4, 8, 10, 29 and are no longer endorsed by experts in the field 3. The generic limitations of retrospective studies apply to our work, as they do to all other outcome data in CS because of the lack of prospective research.…”

Section: Discussionmentioning

confidence: 93%

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Magnetic Resonance Imaging as a Predictor of Survival Free of Life‐Threatening Arrhythmias and Transplantation in Cardiac Sarcoidosis

Ekström

Lehtonen

Hänninen

et al. 2016

JAHA

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BackgroundCardiac magnetic resonance imaging has a key role in today's diagnosis of cardiac sarcoidosis. We set out to investigate whether cardiac magnetic resonance imaging also helps predict outcome in cardiac sarcoidosis.Methods and ResultsOur work involved 59 patients with cardiac sarcoidosis (38 female, mean age 46±10 years) seen at our hospital since February 2004 and followed up after contrast‐enhanced cardiac magnetic resonance imaging. The extent of myocardial late gadolinium enhancement (measured as percentage of left ventricular mass), the volumes and ejection fractions of the left and right ventricles, and the thickness of the basal interventricular septum were determined and analyzed for prognostic significance. By April 2015, 23 patients had reached the study's end point, consisting of a composite of cardiac death (n=3), cardiac transplantation (n=1), and occurrence of life‐threatening ventricular tachyarrhythmias (n=19; ventricular fibrillation in 5 and sustained ventricular tachycardia in 14 patients). In univariate analysis, myocardial extent of late gadolinium enhancement predicted event‐free survival, as did scar‐like thinning (<4 mm) of the basal interventricular septum and the ejection fraction of the right ventricle (P<0.05 for all). In multivariate Cox regression analysis, extent of late gadolinium enhancement was the only independent predictor of outcome events on cardiac magnetic resonance imaging, with a hazard ratio of 2.22 per tertile (95% CI 1.07–4.59). An extent of late gadolinium enhancement >22% (third tertile) had positive and negative predictive values for serious cardiac events of 75% and 76%, respectively.ConclusionsFindings on cardiac magnetic resonance imaging and the extent of myocardial late gadolinium enhancement in particular help predict serious cardiac events in cardiac sarcoidosis.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 93%

Magnetic Resonance Imaging as a Predictor of Survival Free of Life‐Threatening Arrhythmias and Transplantation in Cardiac Sarcoidosis

Ekström

Lehtonen

Hänninen

et al. 2016

JAHA

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“…A British study from the 1980s reported a 40% 5-year survival in CS patients. 37 In a study of 95 patients collected from >40 Japanese hospitals, 5-year survival was 60% overall and 75% in the subgroup of patients diagnosed before autopsy. 20 In the international multicenter study by Okura et al, 15 transplantation-free 5-year survival was 60% overall and 70% in clinically diagnosed patients.…”

Section: Long-term Outcomementioning

confidence: 99%

Cardiac Sarcoidosis

et al. 2015

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Background-This study was designed to assess the epidemiology, characteristics, and outcome of cardiac sarcoidosis (CS) in Finland. Methods and Results-We identified in retrospect all adult (>18 years of age) patients diagnosed with histologically confirmed CS in Finland between 1988 and 2012. A total of 110 patients (71 women) 51±9 years of age (mean±SD) were found and followed up for outcome events to the end of 2013. The annual detection rate of CS increased >20-fold during the 25-year period, reaching 0.31 in 1×10 5 adults between 2008 and 2012. The 2012 prevalence of CS was 2.2 in 1×10 5 . Nearly two thirds of patients had clinically isolated CS. Altogether, 102 of the 110 patients received immunosuppressive therapy, and 56 received an intracardiac defibrillator. Left ventricular function was impaired (ejection fraction <50%) in 65 patients (59%) at diagnosis and showed no overall change over 12 months of steroid therapy. During follow-up (median, 6.6 years), 10 patients died of a cardiac cause, 11 patients underwent transplantation, and another 11 patients suffered an aborted sudden cardiac death. The Kaplan-Meier estimates for 1-, 5-, and 10-year transplantation-free cardiac survival were 97%, 90%, and 83%, respectively. Heart failure at presentation predicted poor outcome (log-rank P=0.0001) with a 10-year transplantation-free cardiac survival of only 53%. Conclusions-The detection rate of CS has increased markedly in Finland over the last 25 years. With current therapy, the prognosis of CS appears better than generally considered, but patients presenting with heart failure still have poor longterm outcome. (Circulation. 2015;131:624-632.

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“…4,5) This paper has reported a very rare case with cardiac sarcoidosis occurring in a young Japanese postpartum female.…”

Section: Discussionmentioning

confidence: 99%

“…Reports of cardiac sarcoidosis related to pregnancy are rare, 6,7) although this disease has been shown to occur more often in the younger generation of both sexes in Western countries. 4,5) Seballos, et al reported a 27 year-old woman who had developed congestive heart failure 5 days after delivery. Steroid therapy was started after a diagnosis of lung and cardiac sarcoidosis by transbronchial and endomyocardial biopsy after the episode of heart failure.…”

Section: Discussionmentioning

confidence: 99%

Postpartum Complete Atrioventricular Block Due to Cardiac Sarcoidosis Steroid Therapy Without Permanent Pacemaker

et al. 2008

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SUMMARYA 32 year-old woman with bilateral hilar lymphadenopathy suffered from syncopal attacks after her first delivery. Electrocardiograms showed complete atrioventricular block (AVB) and myocardial scintigrams demonstrated a decreased uptake in the anteroseptal area. She was diagnosed as having postpartal cardiac acceleration of sarcoidosis. Because she rejected permanent pacemaker implantation, we started steroid therapy under temporary pacing. Fortunately, the treatment was very effective. Even after tapering-off of the steroid, the AVB has never reappeared. Permanent pacemaker implantation with subsequent steroid therapy is generally recommended for complete AVB due to cardiac sarcoidosis. However, steroid therapy alone can be considered for some selected cases. (Int Heart J 2008; 49: 377-384)

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The Prognosis of Sarcoid Heart Disease in the United Kingdom

Cited by 44 publications

References 8 publications

Magnetic Resonance Imaging as a Predictor of Survival Free of Life‐Threatening Arrhythmias and Transplantation in Cardiac Sarcoidosis

Magnetic Resonance Imaging as a Predictor of Survival Free of Life‐Threatening Arrhythmias and Transplantation in Cardiac Sarcoidosis

Cardiac Sarcoidosis

Postpartum Complete Atrioventricular Block Due to Cardiac Sarcoidosis Steroid Therapy Without Permanent Pacemaker

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