BACKGROUND: The usefulness of corticosteroid therapy for cardiac sarcoidosis has not yet been fully clarified. METHODS: Of 40 patients diagnosed with cardiac sarcoidosis, twenty patients complicated by atrioventricular block but normal cardiac function (left ventricular ejection fraction > or = 50%) were divided retrospectively into one group (n = 7) receiving corticosteroids and another (n = 13) not receiving these agents. Over a mean observation period of 79.4 +/- 39.9 months, long-term outcome and laboratory findings were compared between the two groups and side effects also were noted. RESULTS: There were no deaths in the corticosteroid-treated group. In the untreated group, 2 patients died (15.4%). Atrioventricular block resolved in 4 of the 7 patients in the treated group (57.1%), but did not resolve or improve in any of the untreated patients (p < 0.05). Left ventricular ejection fraction did not differ significantly between the treated and untreated groups at the time of initial evaluation (66.7 +/- 6.5% vs. 60.5 +/- 6.4%). In the follow-up period, a marked decline in the ejection fraction had occurred in the untreated group (37.6 +/- 17.3%), but not in the treated group (62.1 +/- 4.4%; p < 0.005). Ventricular tachycardia was not present at the initial assessment in any patient in either group. In the follow-up period, ventricular tachycardia occurred in only 1 of 7 treated patients (14.3%), but was present in 8 of 13 untreated patients (61.5%; p < 0.05). However, side effects of corticosteroid therapy were noted in 6 of the 7 treated patients (85.7%). CONCLUSION: Our findings suggest that corticosteroids are useful in the treatment of cardiac sarcoidosis complicated by atrioventricular block but with normal cardiac function. However, these agents must be used with caution, with the maintenance dose kept as low as possible.
BACKGROUND: The usefulness of corticosteroid therapy for cardiac sarcoidosis has not yet been fully clarified. METHODS: Of 40 patients diagnosed with cardiac sarcoidosis, twenty patients complicated by atrioventricular block but normal cardiac function (left ventricular ejection fraction > or = 50%) were divided retrospectively into one group (n = 7) receiving corticosteroids and another (n = 13) not receiving these agents. Over a mean observation period of 79.4 +/- 39.9 months, long-term outcome and laboratory findings were compared between the two groups and side effects also were noted. RESULTS: There were no deaths in the corticosteroid-treated group. In the untreated group, 2 patients died (15.4%). Atrioventricular block resolved in 4 of the 7 patients in the treated group (57.1%), but did not resolve or improve in any of the untreated patients (p < 0.05). Left ventricular ejection fraction did not differ significantly between the treated and untreated groups at the time of initial evaluation (66.7 +/- 6.5% vs. 60.5 +/- 6.4%). In the follow-up period, a marked decline in the ejection fraction had occurred in the untreated group (37.6 +/- 17.3%), but not in the treated group (62.1 +/- 4.4%; p < 0.005). Ventricular tachycardia was not present at the initial assessment in any patient in either group. In the follow-up period, ventricular tachycardia occurred in only 1 of 7 treated patients (14.3%), but was present in 8 of 13 untreated patients (61.5%; p < 0.05). However, side effects of corticosteroid therapy were noted in 6 of the 7 treated patients (85.7%). CONCLUSION: Our findings suggest that corticosteroids are useful in the treatment of cardiac sarcoidosis complicated by atrioventricular block but with normal cardiac function. However, these agents must be used with caution, with the maintenance dose kept as low as possible.
Authors: Panithaya Chareonthaitawee; Rob S Beanlands; Wengen Chen; Sharmila Dorbala; Edward J Miller; Venkatesh L Murthy; David H Birnie; Edward S Chen; Leslie T Cooper; Roderick H Tung; Eric S White; Salvador Borges-Neto; Marcelo F Di Carli; Robert J Gropler; Terrence D Ruddy; Thomas H Schindler; Ron Blankstein Journal: J Nucl Cardiol Date: 2017-10 Impact factor: 5.952
Authors: Paco E Bravo; Ganesh Raghu; David G Rosenthal; Shana Elman; Bradley J Petek; Laurie A Soine; Jeffrey H Maki; Kelley R Branch; Sofia C Masri; Kristen K Patton; James H Caldwell; Eric V Krieger Journal: Int J Cardiol Date: 2017-03-10 Impact factor: 4.164
Authors: Panithaya Chareonthaitawee; Rob S Beanlands; Wengen Chen; Sharmila Dorbala; Edward J Miller; Venkatesh L Murthy; David H Birnie; Edward S Chen; Leslie T Cooper; Roderick H Tung; Eric S White; Salvador Borges-Neto; Marcelo F Di Carli; Robert J Gropler; Terrence D Ruddy; Thomas H Schindler; Ron Blankstein Journal: J Nucl Med Date: 2017-08 Impact factor: 10.057
Authors: Gillian Murtagh; Luke J Laffin; Kershaw V Patel; Amit V Patel; Catherine A Bonham; Zoe Yu; Karima Addetia; Nadia El-Hangouche; Francesco Maffesanti; Victor Mor-Avi; D Kyle Hogarth; Nadera J Sweiss; John F Beshai; Roberto M Lang; Amit R Patel Journal: Echocardiography Date: 2016-09 Impact factor: 1.724
Authors: Joseph P Lynch; Jennifer Hwang; Jason Bradfield; Michael Fishbein; Kalyanam Shivkumar; Roderick Tung Journal: Semin Respir Crit Care Med Date: 2014-07-09 Impact factor: 3.119