Smedema J P, van Erven L, Schreur J H M, Dijkman-Domanska B, Snoep G, Crijns H J G M
Afd. Cardiologie, Academisch Ziekenhuis Maastricht, Maastricht.
Ned Tijdschr Geneeskd. 2005 May 21;149(21):1168-73.
Cardiac sarcoidosis was diagnosed in 3 patients: 2 men aged 52 and 51 years, respectively, and a woman aged 55 years. Both men had ventricular tachycardia. In the first man, a right-ventricle biopsy revealed a non-caseating granuloma. The second man had active granulomatous cardiac infiltration, according to a gallium scintigram. The first man recovered after receiving immunosuppression, heart-failure medication, and an implantable defibrillator; the second received the same plus radio-frequency catheter ablation, but experienced serious heart failure. The woman was being treated for pulmonary sarcoidosis but complained of progressive cardiac symptoms. She recovered after receiving heart-failure medication, immunosuppression, and a biventricular pacemaker. Sarcoidosis is a multi-system granulomatous disorder of unknown aetiology with cardiac involvement in 20 to 30% of patients, resulting in severe morbidity and mortality. With the help ofgadolinium MRI and positron emission tomography (PET), these conditions can be detected at an earlier stage, which allows for improved evaluation of the efficacy of available therapies. The use of resynchronisation therapy and implantable defibrillators has improved the prognosis of patients with cardiac sarcoidosis.
3例患者被诊断为心脏结节病：分别为2名男性，年龄分别为52岁和51岁，以及1名55岁的女性。两名男性均有室性心动过速。第一名男性经右心室活检发现非干酪样肉芽肿。根据镓闪烁扫描，第二名男性有活动性肉芽肿性心脏浸润。第一名男性在接受免疫抑制、心力衰竭药物治疗和植入式除颤器后康复；第二名男性接受了相同治疗并加上射频导管消融，但出现严重心力衰竭。该女性正在接受肺部结节病治疗，但主诉有进行性心脏症状。她在接受心力衰竭药物治疗、免疫抑制和双心室起搏器治疗后康复。结节病是一种病因不明的多系统肉芽肿性疾病，20%至30%的患者会累及心脏，导致严重的发病率和死亡率。借助钆增强磁共振成像（MRI）和正电子发射断层扫描（PET），这些情况能够在更早阶段被检测到，从而可以更好地评估现有治疗方法的疗效。再同步治疗和植入式除颤器的使用改善了心脏结节病患者的预后。
