30-Year Trends in the Incidence, Characteristics, and Outcome of Cardiac Sarcoidosis in a Nationwide Cohort.

Autor:	Pöyhönen P; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.; Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Lehtonen J; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Velikanova D; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Simonen P; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Uusitalo V; Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.; Clinical Physiology and Nuclear Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Mälkönen H; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Nordenswan HK; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Vihinen T; Heart Center, Turku University Hospital, Turku, Finland., Kaikkonen K; Medical Research Center Oulu, University and University Hospital of Oulu, Oulu, Finland., Haataja P; Heart Hospital, Tampere University Hospital, Tampere, Finland., Kerola T; Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland., Rissanen TT; Heart Center, North Karelia Central Hospital, Joensuu, Finland., Vepsäläinen V; Heart Centre, Kuopio University Hospital, Kuopio, Finland., Alatalo A; South Ostrobothnia Central Hospital, Seinäjoki, Finland., Pietilä-Effati P; Vaasa Central Hospital, Vaasa, Finland., Kupari M; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Jazyk:	angličtina
Zdroj:	JACC. Advances [JACC Adv] 2024 Jul 13; Vol. 3 (8), pp. 101102. Date of Electronic Publication: 2024 Jul 13 (Print Publication: 2024).
DOI:	10.1016/j.jacadv.2024.101102
Abstrakt:	Background: Cardiac sarcoidosis (CS) is a rare but potentially fatal inflammatory cardiomyopathy. Objectives: The authors studied temporal changes in the incidence, characteristics, and outcome of CS. Methods: A retrospective analysis was made of a 30-year nationwide cohort of CS. Results: The cohort comprised 511 patients with a median age of 52 years and female preponderance (69%). Altogether 77, 166, and 268 cases of CS were diagnosed in years 1988 to 2009, 2010 to 2014, and 2015 to 2019, respectively; the 5-year count of 2015 to 2019 was 134-fold the count of 1990 to 1994 (268/2) and 18-fold the count of 2000 to 2004 (268/15). Prior to 2010, compared with the later periods, CS presented more often with ventricular tachycardia/fibrillation (prevalence 36% vs 19% in 2010-2014 and 11% in 2015-2019, P  < 0.001), left ventricular ejection fraction <50% (49%, 35%, and 31%; P  = 0.010), and elevation of natriuretic peptides (87%, 57%, and 49%; P  < 0.001). On magnetic resonance imaging, late gadolinium enhancement involved a median of 15% (IQR: 11%-22%) of left ventricular mass in studies of 1988 to 2009 (n = 16), 15% (IQR: 9%-22%) in studies of 2010 to 2014 (n = 87), and 11% (IQR: 5%-19%) in studies of 2015 to 2019 (n = 150) ( P  = 0.031). The respective 5-year incidences of the composite of death, heart transplantation, left ventricular-assisted device implantation, or ventricular tachyarrhythmia were 40% (95% CI: 29%-51%), 32% (95% CI: 25%-39%), and 23% (95% CI: 16%-30%) ( P  = 0.002). The prognostic trend disappeared after adjustment for differences in the presenting phenotype. Conclusions: Diagnoses of incident CS have increased exponentially in Finland. Concurrently, the phenotype has turned milder and prognosis better, suggesting detection of CS at an earlier stage of its course. Competing Interests: Dr Pöyhönen was supported by the 10.13039/501100003125Finnish Cultural Foundation (Helsinki, Finland), 10.13039/501100005633Finnish Foundation for Cardiovascular Research (Helsinki, Finland) and Finnish government grant for medical research (Helsinki, Finland). Dr Uusitalo has scientific collaboration with lecture fees with GE Healthcare; and has received lecture fee and advisory board activity with Pfizer. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (© 2024 The Authors.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu