Department of Cardiovascular Medicine, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Cardiovascular Medicine, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Int J Cardiol. 2024 Oct 15;413:132368. doi: 10.1016/j.ijcard.2024.132368. Epub 2024 Jul 25.
The prognostic impact of extracardiac sarcoidosis remains unknown in cardiac sarcoidosis (CS). We aimed to evaluate the influence of extracardiac sarcoidosis on clinical outcomes and the effect of continued outpatient visits for screening of cardiac involvement.
Ninety-nine patients with CS were divided into two groups: patients with systemic CS who had prior extracardiac sarcoidosis, patients with isolated CS who had no prior extracardiac sarcoidosis. Patients with systemic CS were divided according to the continuation of outpatient visits. The endpoint was cardiac death, fatal ventricular arrhythmia, or hospitalization for heart failure.
At the time of diagnosing CS, patients with isolated CS had a higher prevalence of high-grade atrioventricular block or fatal ventricular arrhythmia, and left ventricular contractile dysfunction than those with systemic CS. Over a median follow-up of 42 months, cardiac events occurred in 19 (37%) of 52 patients with systemic CS and in 27 (57%) of 47 patients with isolated CS. The event-free survival rate was worse in patients with isolated CS than in those with systemic CS. Cox proportional hazard analysis showed that the absence of prior extracardiac sarcoidosis was an independent predictor of adverse outcomes. Patients with systemic CS who ceased outpatient visits had a lower left ventricular ejection fraction with severe heart failure symptoms and a worse event-free survival rate than those who continued outpatient visits.
The presence of extracardiac sarcoidosis is associated with clinical outcomes. The cessation of screening for cardiac involvement after diagnosing extracardiac sarcoidosis is associated with adverse outcomes.
在心脏结节病（CS）中，心脏外结节病的预后影响尚不清楚。我们旨在评估心脏外结节病对临床结局的影响，以及继续门诊筛查心脏受累的效果。
将 99 例 CS 患者分为两组：有既往心脏外结节病的系统性 CS 患者和无既往心脏外结节病的孤立性 CS 患者。根据门诊随访情况对系统性 CS 患者进行分组。终点是心脏性死亡、致命性室性心律失常或心力衰竭住院。
在诊断 CS 时，孤立性 CS 患者的高级别房室传导阻滞或致命性室性心律失常以及左心室收缩功能障碍的发生率高于系统性 CS 患者。在中位随访 42 个月期间，52 例系统性 CS 患者中有 19 例（37%）和 47 例孤立性 CS 患者中有 27 例（57%）发生了心脏事件。孤立性 CS 患者的无事件生存率较系统性 CS 患者差。Cox 比例风险分析显示，无既往心脏外结节病是不良结局的独立预测因子。停止门诊随访的系统性 CS 患者的左心室射血分数较低，有严重心力衰竭症状，无事件生存率较继续门诊随访的患者差。
心脏外结节病的存在与临床结局相关。诊断心脏外结节病后停止筛查心脏受累与不良结局相关。
