Advanced Heart Failure/Transplant Cardiology Section, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Advanced Heart Failure/Transplant Cardiology Section, Division of Cardiology, Columbia University School of Medicine, New York, New York.
J Card Fail. 2022 Jan;28(1):113-132. doi: 10.1016/j.cardfail.2021.06.016. Epub 2021 Jul 11.
The prevalence of sarcoidosis-related cardiomyopathy is increasing. Sarcoidosis impacts cardiac function through granulomatous infiltration of the heart, resulting in conduction disease, arrhythmia, and/or heart failure. The diagnosis of cardiac sarcoidosis (CS) can be challenging and requires clinician awareness as well as differentiation from overlapping diagnostic phenotypes, such as other forms of myocarditis and arrhythmogenic cardiomyopathy. Clinical manifestations, extracardiac involvement, histopathology, and advanced cardiac imaging can all lend support to a diagnosis of CS. The mainstay of therapy for CS is immunosuppression; however, no prospective clinical trials exist to guide management. Patients may progress to developing advanced heart failure or ventricular arrhythmia, for which ventricular assist device therapies or heart transplantation may be considered. The existing knowledge gaps in CS call for an interdisciplinary approach to both patient care and future investigation to improve mechanistic understanding and therapeutic strategies.
结节病相关性心肌病的患病率正在上升。结节病通过心脏的肉芽肿浸润影响心脏功能，导致传导疾病、心律失常和/或心力衰竭。心脏结节病（CS）的诊断具有挑战性，需要临床医生的认识，并需要与重叠的诊断表型（如其他类型的心肌炎和致心律失常性心肌病）相区分。临床表现、心脏外受累、组织病理学和先进的心脏成像都可以支持 CS 的诊断。CS 的主要治疗方法是免疫抑制；然而，目前没有前瞻性临床试验来指导管理。患者可能会发展为晚期心力衰竭或室性心律失常，可能需要考虑心室辅助装置治疗或心脏移植。CS 中的现有知识空白需要采取多学科方法来进行患者护理和未来研究，以改善对发病机制的理解和治疗策略。
