Quijano-Campos Juan Carlos, Sekhri Neha, Thillai Muhunthan, Sanders Julie
William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7DN, UK.
Eur Heart J Open. 2023 Feb 18;3(2):oead009. doi: 10.1093/ehjopen/oead009. eCollection 2023 Mar.
People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. CS can result in a constellation of intrusive symptoms (such as palpitations, dizziness, syncope/pre-syncope, chest pain, dyspnoea, orthopnoea, or peripheral oedema) and/or life-threatening episodes, requiring consideration of invasive cardiac procedures for diagnosis and for the management of acute events. Additionally, the presence of multisystemic involvement and persistent non-specific sarcoidosis symptoms negatively affect HRQoL. A systematic review was undertaken to explore the impact of CS on HRQoL in adults with CS. Multiple bibliographic databases were searched for studies with HRQoL as primary or secondary outcomes in CS (PROSPERO registration: CRD42019119752). Data extraction and quality assessments were undertaken independently by two authors. From the initial 1609 identified records, only 11 studies included CS patients but none specifically reported HRQoL scores for CS patients. The average representation of CS patients was 14.5% within these cohorts (range 2-22%). The majority (73%) was conducted in single-centre tertiary care settings, and only one study (9%) included longitudinal HRQoL data. CS patients were among those sarcoidosis patients with impaired HRQoL and worse outcomes, requiring higher doses of sarcoidosis-specific therapy which contribute to further deterioration of HRQoL. Sarcoidosis studies do not incorporate stratified HRQoL scores for CS patients. While there is a need for longitudinal and multicentre studies assessing HRQoL outcomes in CS cohorts, the development of CS-specific tools is also needed.
与其他结节病表现相比，心脏结节病（CS）患者可能具有更差的临床结局，并且在健康相关生活质量（HRQoL）方面的损害更大。CS可导致一系列侵扰性症状（如心悸、头晕、晕厥/先兆晕厥、胸痛、呼吸困难、端坐呼吸或外周水肿）和/或危及生命的发作，需要考虑采用侵入性心脏检查来进行诊断和管理急性事件。此外，多系统受累和持续的非特异性结节病症状的存在会对HRQoL产生负面影响。本研究进行了一项系统评价，以探讨CS对成年CS患者HRQoL的影响。检索了多个文献数据库，查找以HRQoL作为CS主要或次要结局的研究（PROSPERO注册号：CRD42019119752）。由两位作者独立进行数据提取和质量评估。从最初识别出的1609条记录中，只有11项研究纳入了CS患者，但没有一项专门报告CS患者的HRQoL评分。在这些队列中，CS患者的平均占比为14.5%（范围为2%-22%）。大多数研究（73%）在单中心三级医疗机构进行，只有一项研究（9%）纳入了纵向HRQoL数据。CS患者属于HRQoL受损且结局较差的结节病患者，需要更高剂量的结节病特异性治疗，这会导致HRQoL进一步恶化。结节病研究未纳入CS患者的分层HRQoL评分。虽然需要进行纵向和多中心研究来评估CS队列中的HRQoL结局，但也需要开发针对CS的工具。
