Morphologic Features of Cardiac Sarcoidosis in Native Hearts of Patients Having Cardiac Transplantation

Described herein are 10 patients who underwent cardiac transplantation (CT) for severe chronic systolic heart failure resulting from cardiac sarcoidosis. None had the diagnosis of sarcoidosis established before CT except for the 3 patients who earlier had had a portion of left ventricular wall excised for insertion of a left ventricular assist device and non-caseating granulomas were present in the removed myocardium. Although none of the 10 patients had significant narrowing of any of the epicardial coronary arteries, all had focal scarring of the walls of the left and right ventricles and ventricular septum and all had dilated ventricular cavities. The patients with the most ventricular wall scarring tended to have the fewest sarcoid granulomas in the ventricular walls. Two patients had no sarcoid granulomas in the excised heart although one did have typical sarcoid granulomas in the portion of left ventricular wall excised to insert a left ventricular assist device. Patients with cardiac sarcoidosis severe enough to warrant CT had characteristic cardiac ventricular morphologic findings, and no dysfunction of other non-cardiac organs, making clinical diagnosis of cardiac sarcoidosis rather difficult.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Tags: Cardiomyopathy Source Type: research

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Cardiac sarcoidosis (CS) is frequently difficult to treat. Infliximab (IFX) is useful for extracardiac sarcoidosis, but its use in CS has been limited due to concerns about cardiotoxicity and an FDA blackbox warning about use in heart failure. We reviewed 36 consecutive patients treated with infliximab for CS refractory to standard therapies. IFX was initiated for patients with refractory dysrhythmias, moderate to severe cardiomyopathy, and evidence of persistent  F-18 fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan, despite standard therapies.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Discussion Barth syndrome is characterized by a dilated cardiomyopathy, proximal skeletal muscle weakness, neutropenia and short stature that usually presents at birth or soon after. It is a rare X-linked recessive disease process caused by mutations in the TAZ gene. The TAZ gene codes for tafazzin which alters cardiolipin in mitochondria. Characteristic facies can be seen especially in infancy including a tall and broad forehead, prominent chin and full cheeks, larger ears, and deep-set eyes. Most patients present at birth or soon afterwards but some may not until later in life. Life expectancy is reduced with many childr...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
AbstractPurposeTo investigate inpatient prevalence, expenditures, and comorbidities of hospitalized patients with sarcoidosis in the USA.MethodsPatients with sarcoidosis were identified within the Nationwide Inpatient Sample (NIS) database for the years 2013 and 2014 using the respective ICD-9 diagnostic code. Data on patient and hospital characteristics, comorbidities, total hospital costs, and total hospitalization charges were collected. A propensity-matched cohort of patients without sarcoidosis from the same database was created and used as comparators for the analysis of comorbidities.ResultsA cohort of 78,055 patien...
Source: Lung - Category: Respiratory Medicine Source Type: research
Publication date: Available online 6 February 2019Source: Journal of Cardiology CasesAuthor(s): Kyoko Odawara, Takahiro Inoue, Yoshitaka HirookaAbstractA 75-year-old woman with no significant medical history was admitted to our hospital with congestive heart failure. Echocardiography revealed left ventricle (LV) systolic dysfunction [LV ejection fraction (LVEF) 18%] and diffuse LV hypokinesis mimicking dilated cardiomyopathy. Her brain natriuretic peptide (BNP) level was elevated (1214.3 pg/mL). Standard medications for heart failure failed to ameliorate her cardiac failure symptoms. Echocardiography on admission re...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
Conclusion: These low voltages are like those found in patients with carcinoid syndrome, severe cardiac adiposity, cardiac amyloidosis, and cardiac sarcoidosis.Cardiology 2018;141:172 –175
Source: Cardiology - Category: Cardiology Source Type: research
AbstractCardiac sarcoidosis (CS) remains an intriguing infiltrating disorder and one of the most important forms of inflammatory cardiomyopathy. Identification of patients with CS is of extreme importance because they are at higher risk of sudden death, and heart-failure progression. And while it remains a diagnostic conundrum, a great amount of experience has been accumulated over the last decade with the advent of fluorine-18 fluorodeoxyglucose positron emission tomography and cardiac magnetic resonance with late gadolinium enhancement imaging. They have both proven to be advanced imaging techniques that provide importan...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
ConclusionIn a large series of CS subjects, rates of ventricular arrhythmia and heart failure events remain high with no treatment regimen clearly associated with better outcome. Patients with cardiomyopathy at diagnosis were more likely to reach the composite endpoint.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Cardiac resynchronization therapy (CRT) has been shown to be beneficial in patients with medically refractory heart failure. While it has been found to be effective in a wide range of etiologies for non-ischemic cardiomyopathy, its role in improving remodeling and survival of patients with cardiac sarcoidosis (CS) remains undefined. We performed a retrospective review of all patients at our institution with CS who underwent implantation of a CRT device between 2007 and 2017. The outcomes of this population were compared to the outcomes of a cohort of patients with non-ischemic cardiomyopathy with an etiology other than sarcoidosis.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Myocarditis due to granulomatous inflammation is being increasingly recognized now compared to past when the diagnosis was usually made during autopsy. It comprises cardiac sarcoidosis (CS), cardiac tuberculosis (CTB), and other rare granulomatous disorders. It presents as ventricular tachycardia, atrioventricular conduction block with or without cardiomyopathy, and heart failure. The paucity of constitutional symptoms and the lack of awareness result in delayed diagnosis.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
Myocarditis due to granulomatous inflammation is being increasingly recognised compared to past when the diagnosis was usually made during autopsy. It comprises cardiac sarcoidosis (CS), cardiac tuberculosis (CTB) and other rare granulomatous disorders. It presents as ventricular tachycardias, atrio-ventricular conduction blocks with or without cardiomyopathy and heart failure. Paucity of constitutional symptoms and lack of awareness results in delayed diagnosis.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
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