Challenges in Cardiac and Pulmonary Sarcoidosis: JACC State-of-the-Art Review

Maria Giovanna Trivieri, Paolo Spagnolo, David Birnie, Peter Liu, Wonder Drake, Jason C. Kovacic, Robert Baughman, Zahi A. Fayad, Marc A. Judson

Research output: Contribution to journalReview articlepeer-review

102 Citations (Scopus)

Abstract

Sarcoidosis is a complex disease with heterogeneous clinical presentations that can affect virtually any organ. Although the lung is typically the most common organ involved, combined pulmonary and cardiac sarcoidosis (CS) account for most of the morbidity and mortality associated with this disease. Pulmonary sarcoidosis can be asymptomatic or result in impairment in quality of life and end-stage, severe, and/or life-threatening disease. The latter outcome is seen almost exclusively in those with fibrotic pulmonary sarcoidosis, which accounts for 10% to 20% of pulmonary sarcoidosis patients. CS is problematic to diagnose and may cause significant morbidity and death from heart failure or ventricular arrhythmias. The diagnosis of CS usually requires surrogate cardiac imaging biomarkers, as endomyocardial biopsy has relatively low yield, even with directed electrophysiological mapping. Treatment of CS is often multifactorial, involving a combination of antigranulomatous therapy and pharmacotherapy for cardiac arrhythmias and/or heart failure in addition to device placement and cardiac transplantation.
Original languageEnglish
Pages (from-to)1878-1901
Number of pages24
JournalJournal of the American College of Cardiology
Volume76
Issue number16
DOIs
Publication statusPublished - 20 Oct 2020
Externally publishedYes

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