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30-Year Trends in the Incidence, Characteristics, and Outcome of Cardiac Sarcoidosis in a Nationwide Cohort.
Pöyhönen, Pauli; Lehtonen, Jukka; Velikanova, Diana; Simonen, Piia; Uusitalo, Valtteri; Mälkönen, Henriikka; Nordenswan, Hanna-Kaisa; Vihinen, Tapani; Kaikkonen, Kari; Haataja, Petri; Kerola, Tuomas; Rissanen, Tuomas T; Vepsäläinen, Ville; Alatalo, Aleksi; Pietilä-Effati, Päivi; Kupari, Markku.
Afiliación
  • Pöyhönen P; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Lehtonen J; Radiology, 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; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Mälkönen H; Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Nordenswan HK; Clinical Physiology and Nuclear Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Vihinen T; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Kaikkonen K; Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Haataja P; Heart Center, Turku University Hospital, Turku, Finland.
  • Kerola T; Medical Research Center Oulu, University and University Hospital of Oulu, Oulu, Finland.
  • Rissanen TT; Heart Hospital, Tampere University Hospital, Tampere, Finland.
  • Vepsäläinen V; Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland.
  • Alatalo A; Heart Center, North Karelia Central Hospital, Joensuu, Finland.
  • Pietilä-Effati P; Heart Centre, Kuopio University Hospital, Kuopio, Finland.
  • Kupari M; South Ostrobothnia Central Hospital, Seinäjoki, Finland.
JACC Adv ; 3(8): 101102, 2024 Aug.
Article en En | MEDLINE | ID: mdl-39105120
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos