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Natural History of Patients Diagnosed with Cardiac Sarcoidosis at Left Ventricular Assist Device Implantation or Cardiac Transplantation

Authors :
Richard C. Daly
Mohamed Y. Elwazir
John A. Schirger
Andrew N. Rosenbaum
Nikhil Kolluri
Suraj Kapa
Leslie T. Cooper
Lori A. Blauwet
John M. Stulak
Tyler Schmidt
Source :
ASAIO journal (American Society for Artificial Internal Organs : 1992). 67(5)
Publication Year :
2021

Abstract

To our knowledge, natural history has not been reported for cardiac sarcoidosis (CS) diagnosed by pathologic evaluation of the apical core at left ventricular assist device (LVAD) implantation or cardiac transplantation. We retrospectively identified 232 consecutive patients meeting CS criteria. Of these patients, 54 were diagnosed by pathologic confirmation of CS, 10 after evaluation of the apical core (LVAD implant) or explanted heart (transplant). We compared clinical characteristics at initial evaluation and outcomes for these 10 patients with those of 10 patients with known CS before LVAD implant/transplant. In the study group, five patients (50%) had confirmed extracardiac sarcoidosis before LVAD implant/transplant; five had not been diagnosed with sarcoidosis. Mean (standard deviation) left ventricular ejection fraction at initial evaluation was 23% (16%), and left ventricular end-diastolic dimension was 61 (10) mm. Four patients died during follow-up; however, no survival difference was found for the 10 patients diagnosed incidentally and the group with a previous diagnosis or institutional LVAD/transplant cohorts. Patients diagnosed with CS on pathological examination of the apical core/explanted heart may have severe dilated cardiomyopathy as the initial presentation. Outcomes for patients with CS after advanced heart failure therapies may be comparable with those of non-CS patients.

Details

ISSN :
1538943X
Volume :
67
Issue :
5
Database :
OpenAIRE
Journal :
ASAIO journal (American Society for Artificial Internal Organs : 1992)
Accession number :
edsair.doi.dedup.....47600f7880dfa1590f00698056f74899