Keck School of Medicine of USC, Los Angeles, California 90033, USA.
Curr Opin Pulm Med. 2011 Sep;17(5):308-15. doi: 10.1097/MCP.0b013e328349637a.
Cardiac involvement in sarcoidosis is not always associated with a wide spread of disease, but when present, has been linked with a relatively poor prognosis. This review will delve into new genetic associations, recently reported clinical manifestations and complementary radiographic tools that aid with diagnosis and follow-up.
Clinical manifestations, diagnosis and management remain an intricate maze.Genetic predisposition and associations that include HLA class II molecules and polymorphisms in tumor necrosis factor-α have been reported due in part to weakened arguments suggesting autoimmune disorders or dysregulation. In addition, further symptomatologies have been reported that assist with diagnosis.Radiographic tools including Microvolt T wave alternans, cardiovascular magnetic resonance, late gadolinium enhancement and cardiac assist devices, recently being used, are shedding some light on the diagnostic challenges.
Cardiac involvement in sarcoidosis remains a challenging dilemma, relying on a combination of clinical findings and imaging abnormalities because no single diagnostic test has yet emerged with a high degree of specificity and sensitivity. Given its life-threatening nature, prompt establishment of a diagnosis, an aggressive management strategy and devices to prolong life should be pursued.
结节病的心脏受累并不总是与广泛的疾病有关,但当存在时,与相对较差的预后有关。这篇综述将深入探讨新的遗传相关性、最近报道的临床表现和有助于诊断和随访的补充影像学工具。
临床表现、诊断和治疗仍然是一个复杂的难题。由于自身免疫性疾病或调节异常的证据较弱,部分原因是报告了遗传易感性和包括 HLA Ⅱ类分子和肿瘤坏死因子-α多态性在内的关联。此外,还报告了一些有助于诊断的进一步症状。最近使用的微伏 T 波交替、心血管磁共振、晚期钆增强和心脏辅助装置等影像学工具为诊断挑战提供了一些线索。
结节病的心脏受累仍然是一个具有挑战性的难题,需要结合临床表现和影像学异常,因为还没有出现一种具有高度特异性和敏感性的单一诊断测试。鉴于其危及生命的性质,应迅速确立诊断,采取积极的治疗策略和延长生命的装置。