The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.
Diagnosing isolated cardiac sarcoidosis
Abstract
OBJECTIVES: Cardiac sarcoidosis (CS) without clinically apparent extracardiac disease may escape detection because of the poor sensitivity of endomyocardial biopsy (EMB). We set out to analyse our experience of repeated and imaging-guided biopsies in clinically isolated CS. METHODS: We retrospectively reviewed the medical records, laboratory test results, imaging studies and pathological analyses of 74 patients with either histologically proven or clinically probable CS at our institution between January 2000 and December 2010. RESULTS: Fifty-two patients had histologically proven CS, of whom 33 (26 women) had disease that was clinically isolated to the heart. Sarcoidosis was detected in the first EMB in 10 of the 31 patients who underwent biopsy. CS was found by repeated EMBs, targeted by cardiac imaging, in seven additional patients, and 11 patients were diagnosed by sampling 18-F-fluorodeoxyglucose position emission tomography-positive mediastinal lymph nodes at mediastinoscopy. Together, the first biopsy (cardiac or mediastinal lymph node) provided the diagnosis in 34%, the second biopsy in 31% and the third in 22% of biopsied patients with isolated CS. Four (13%) of the remaining diagnosis were made after cardiac transplantation and one in a patient who did not undergo biopsy) at autopsy after sudden cardiac death. CONCLUSIONS: Cardiac sarcoidosis may present without clinically apparent disease in other organs. At least two-thirds of patients remain undiagnosed after a single EMB session. The detection rate can be improved by repeated and imaging-guided cardiac or mediastinal lymph-node biopsies. Nevertheless, false-negative biopsy results remain a problem in CS patients with no apparent extracardiac disease.
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Cites
Underlying Causes and Long-Term Survival in Patients with Initially Unexplained Cardiomyopathy
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Cited by
Birnie, D. H., Nery, P. B., Ha, A. C., & Beanlands, R. S. B. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.03.605 · Cited by 569
Diagnosis, Treatment, and Outcome of Giant-Cell Myocarditis in the Era of Combined Immunosuppression
Kandolin, R., Lehtonen, J., Salmenkivi, K., Räisänen-Sokolowski, A., Lommi, J., & Kupari, M. (2013) · Circulation: Heart Failure · doi:10.1161/circheartfailure.112.969261 · Cited by 265
Self-citationSeferović, P. M., Tsutsui, H., McNamara, D. M., Ristić, A. D., Basso, C., Bozkurt, B., Cooper, L. T., Filippatos, G., Ide, T., Inomata, T., et al. (2021) · European Journal of Heart Failure · doi:10.1002/ejhf.2190 · Cited by 219
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Epidemiology, Pathogenesis, and Diagnosis of Cardiac Sarcoidosis
Mathai, S. V., Patel, S., Jorde, U. P., & Rochlani, Y. (2022) · Methodist DeBakey Cardiovascular Journal · doi:10.14797/mdcvj.1057 · Cited by 38
Metadata
- Authors
- Kandolin, R., Lehtonen, J., Graner, M., Schildt, J., Salmenkivi, K., Kivistö, S. M., & Kupari, M.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 2011-06-01
- Volume
- 270
- Issue
- 5
- Pages
- 461-468
- ISSN
- 0954-6820 (ISSN-L)
- OpenAlex
- W1499209871
- Cited by
- 253
- References
- 22
- FWCI
- 4.82
- Type
- journal article
- Language
- en
- Open access
- closed
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