TY - JOUR
T1 - Impact of extracardiac sarcoidosis on clinical outcomes in patients with cardiac sarcoidosis
T2 - Importance of continued screening for cardiac involvement
AU - Takaya, Yoichi
AU - Nakagawa, Koji
AU - Miyoshi, Toru
AU - Nishii, Nobuhiro
AU - Morita, Hiroshi
AU - Nakamura, Kazufumi
AU - Yuasa, Shinsuke
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2024/10/15
Y1 - 2024/10/15
N2 - Background: The prognostic impact of extracardiac sarcoidosis remains unknown in cardiac sarcoidosis (CS). We aimed to evaluate the influence of extracardiac sarcoidosis on clinical outcomes and the effect of continued outpatient visits for screening of cardiac involvement. Methods: Ninety-nine patients with CS were divided into two groups: patients with systemic CS who had prior extracardiac sarcoidosis, patients with isolated CS who had no prior extracardiac sarcoidosis. Patients with systemic CS were divided according to the continuation of outpatient visits. The endpoint was cardiac death, fatal ventricular arrhythmia, or hospitalization for heart failure. Results: At the time of diagnosing CS, patients with isolated CS had a higher prevalence of high-grade atrioventricular block or fatal ventricular arrhythmia, and left ventricular contractile dysfunction than those with systemic CS. Over a median follow-up of 42 months, cardiac events occurred in 19 (37%) of 52 patients with systemic CS and in 27 (57%) of 47 patients with isolated CS. The event-free survival rate was worse in patients with isolated CS than in those with systemic CS. Cox proportional hazard analysis showed that the absence of prior extracardiac sarcoidosis was an independent predictor of adverse outcomes. Patients with systemic CS who ceased outpatient visits had a lower left ventricular ejection fraction with severe heart failure symptoms and a worse event-free survival rate than those who continued outpatient visits. Conclusions: The presence of extracardiac sarcoidosis is associated with clinical outcomes. The cessation of screening for cardiac involvement after diagnosing extracardiac sarcoidosis is associated with adverse outcomes.
AB - Background: The prognostic impact of extracardiac sarcoidosis remains unknown in cardiac sarcoidosis (CS). We aimed to evaluate the influence of extracardiac sarcoidosis on clinical outcomes and the effect of continued outpatient visits for screening of cardiac involvement. Methods: Ninety-nine patients with CS were divided into two groups: patients with systemic CS who had prior extracardiac sarcoidosis, patients with isolated CS who had no prior extracardiac sarcoidosis. Patients with systemic CS were divided according to the continuation of outpatient visits. The endpoint was cardiac death, fatal ventricular arrhythmia, or hospitalization for heart failure. Results: At the time of diagnosing CS, patients with isolated CS had a higher prevalence of high-grade atrioventricular block or fatal ventricular arrhythmia, and left ventricular contractile dysfunction than those with systemic CS. Over a median follow-up of 42 months, cardiac events occurred in 19 (37%) of 52 patients with systemic CS and in 27 (57%) of 47 patients with isolated CS. The event-free survival rate was worse in patients with isolated CS than in those with systemic CS. Cox proportional hazard analysis showed that the absence of prior extracardiac sarcoidosis was an independent predictor of adverse outcomes. Patients with systemic CS who ceased outpatient visits had a lower left ventricular ejection fraction with severe heart failure symptoms and a worse event-free survival rate than those who continued outpatient visits. Conclusions: The presence of extracardiac sarcoidosis is associated with clinical outcomes. The cessation of screening for cardiac involvement after diagnosing extracardiac sarcoidosis is associated with adverse outcomes.
KW - Cardiac sarcoidosis
KW - Extracardiac sarcoidosis
KW - Outcome
UR - http://www.scopus.com/inward/record.url?scp=85199395509&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85199395509&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2024.132368
DO - 10.1016/j.ijcard.2024.132368
M3 - Article
C2 - 39025136
AN - SCOPUS:85199395509
SN - 0167-5273
VL - 413
JO - International Journal of Cardiology
JF - International Journal of Cardiology
M1 - 132368
ER -