Cardiac involvement in patients with pulmonary sarcoidosis assessed at two university medical centers in the Netherlands.
OBJECTIVE
We aimed to determine cardiac involvement in patients with pulmonary sarcoidosis (PS) followed up at two university medical centers in the Netherlands.


METHODS
We reviewed the findings in consecutive patients assessed by our departments during 1998 to 2004, and classified them as patients who had presented with symptoms of cardiac sarcoidosis (CS) [group A], and those who had been screened for this condition (group B).


METHODS
Two university medical centers in the Netherlands.


METHODS
One hundred one patients (69 men [mean age, 47.6 years] and 32 women [mean age, 47.3 years]) with biopsy-proven PS.


METHODS
Twelve-lead ECG (n = 101), ambulatory ECG (n = 74), echocardiography (n = 80), (201)Tl single-photon emission CT (n = 61), cardiac MRI (n = 87), coronary angiography to exclude coronary artery disease (n = 17), and endomyocardial biopsy (n = 9).


METHODS
ECG, structural, and functional cardiac abnormalities according to the modified guidelines of the Japanese Ministry of Health and Welfare (1993).


RESULTS
Sixteen of 19 patients in group A and 3 of 82 patients in group B received a diagnosis of CS. During a mean follow-up of 1.7 years (range, 3 months to 4 years), four patients in group A died (20%) and nine patients received a pacemaker and/or an implantable cardioverter-defibrillator (47%), while the patients in group B had an uncomplicated course.


CONCLUSIONS
Once symptomatic CS develops in PS patients, the prognosis becomes very grim. In contrast, the prognosis in asymptomatic cardiac involvement in PS patients is good. Considering the poor prognosis of symptomatic CS, pulmonologists should consider regular screening of their PS patients for cardiac involvement with straightforward detection methods.
Department of Cardiology, University Hospital Maastricht, Dr Debyelaan 25, 6202 AZ Maastricht, the Netherlands. j.smedema@cardio.azm.nl
Jan-Peter
JP
Smedema
Gabriel
G
Snoep
Marinus P G
MP
van Kroonenburgh
Robert-Jan
RJ
van Geuns
Willem R M
WR
Dassen
Anton P
AP
Gorgels
Harry J G M
HJ
Crijns
D000328:Adult; D000368:Aged; D001706:Biopsy; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000453:epidemiology; D016009:Chi-Square Distribution; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012507:Sarcoidosis / Q000175:diagnosis* / Q000453:epidemiology; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000453:epidemiology; D018709:Statistics, Nonparametric; D015899:Tomography, Emission-Computed, Single-Photon