[Cardiac sarcoidosis: Diagnosis and therapeutic challenges]

F Cohen Aubart; H Nunes; A Mathian; J Haroche; M Hié; D Le-Thi Huong Boutin; P Cluzel; M Soussan; X Waintraub; P Fouret; D Valeyre; Z Amoura

doi:10.1016/j.revmed.2016.03.003

[Cardiac sarcoidosis: Diagnosis and therapeutic challenges]

Rev Med Interne. 2017 Jan;38(1):28-35. doi: 10.1016/j.revmed.2016.03.003. Epub 2016 Jul 7.

[Article in French]

Authors

F Cohen Aubart¹, H Nunes², A Mathian³, J Haroche³, M Hié⁴, D Le-Thi Huong Boutin³, P Cluzel⁵, M Soussan⁶, X Waintraub⁷, P Fouret⁸, D Valeyre², Z Amoura³

Affiliations

¹ Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France. Electronic address: [email protected].
² Service de pneumologie, hôpital Avicenne, AP-HP, université Paris XIII, 93000 Bobigny, France.
³ Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France.
⁴ Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
⁵ Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France; Service de radiologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75651 Paris cedex 13, France.
⁶ Service de médecine nucléaire, hôpital Avicenne, AP-HP, 93000 Bobigny, France.
⁷ Service de cardiologie, unité de rythmologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75651 Paris cedex 13, France.
⁸ Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France; Service d'anatomo-pathologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75651 Paris cedex 13, France.

PMID: 27211064
DOI: 10.1016/j.revmed.2016.03.003

Abstract

Sarcoidosis is a granulomatous disorder of unknown cause characterized by non-caseating granuloma in young adults. Cardiac involvement is rare and range from 2 to 75% depending on diagnostic criteria. Cardiac involvement in sarcoidosis may be asymptomatic or may manifest as rhythm/conduction troubles or congestive heart failure. The diagnosis and treatment of cardiac sarcoidosis may be challenging. However, advances have come in recent years from the use of cardiac MRI and ¹⁸FDG-TEP scanner, as well as from the stratification of the risk of ventricular tachycardia/fibrillation. Due to the rarity of the disease, there is no reliable prospective large study to guide therapeutic strategy for cardiac sarcoidosis. Corticosteroids are probably efficacious, in particular in case of atrio-ventricular block or moderate heart failure. Immunosuppressive drugs have not been largely studied but methotrexate could be helpful. In refractory forms, TNF-α antagonists have been used with success.

Keywords: Corticosteroids; Corticostéroïdes; Cœur; Heart; Rhythm and conduction troubles; Sarcoidosis; Sarcoïdose; Troubles du rythme.

Publication types

Review

MeSH terms

Adult
Cardiomyopathies / diagnosis*
Cardiomyopathies / epidemiology
Cardiomyopathies / therapy*
Diagnosis, Differential
Humans
Prevalence
Sarcoidosis / diagnosis*
Sarcoidosis / epidemiology
Sarcoidosis / therapy*
Young Adult