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Sarcoidosis diagnosed on granulomas in the explanted heart after transplantation: Results of a French nationwide study.

Abstract：

BACKGROUND:Cardiac sarcoidosis (CS) is a challenging diagnosis. Patients may progress to end-stage congestive heart failure and require cardiac transplantation without ever having been diagnosed. Characteristics and outcomes of patients with granulomas in the explanted hearts are unknown. METHODS:All French heart transplantation centers were contacted to participate in the study. Each center searched through local databases for the cases of non-caseating granuloma in the explanted hearts between 2000 and 2017. Data before and after transplantation were recorded from medical charts. Survival of CS and all- cause heart transplantation patients were compared. RESULTS:Fifteen patients (10 men, 5 women) received a diagnosis of CS based on pathologic data of the explanted heart and were recruited for the study. All patients were diagnosed as non-ischemic dilated or hypertrophic cardiomyopathy and presented congestive heart failure. Eight patients (53%) had ventricular rhythm disturbances, and 3 (20%) a complete heart block. Ten out of 13 patients (77%) had extracardiac radiological signs compatible with sarcoidosis on chest computed tomography (CT) scans. One patient died 3 months after transplantation from infectious complications. The 14 remaining patients were still alive at the end of the study (median follow-up of 28.8 months). One patient had a second heart transplantation 5 years later because of chronic allograft vasculopathy. One patient presented a relapse of CS confirmed by myocardial biopsies 9 years after transplantation, requiring an escalation of immunosuppressive therapy. CONCLUSION:CS may be undiagnosed before heart transplantation. In 77% of cases, sarcoidosis could have been detected before transplantation with non-invasive imaging techniques.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Chazal T,Varnous S,Guihaire J,Goeminne C,Launay D,Boignard A,Vermes E,Dorent R,Camilleri L,Lelong B,Epailly E,Lebreton G,Waintraub X,Cluzel P,Maksud P,Fouret P,Leprince P,Grenier P,Amoura Z,Cohen Aubart F

doi

10.1016/j.ijcard.2019.12.066

subject

Has Abstract

pub_date

2020-05-15 00:00:00

pages

94-100

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(18)36864-5

journal_volume

307

pub_type

杂志文章

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