title: Clinical analysis of sarcoidosis presenting with heterochronic cardiac involvement.
abstract: OBJECTIVE
  A variety of markers, such as serum angiotensin-converting enzyme (sACE) and CXR have been used to evaluate the disease activity and progression of sarcoidosis. There are patients who have developed cardiac involvement several years after the initial diagnosis despite stable or decreased disease activity. This study clarified the clinical characteristics of those patients.
  
  
  METHODS
  A total of 141 consecutive patients treated for sarcoidosis were studied. Heterochronic cardiac sarcoidosis was defined as the sudden onset of cardiac manifestations more than 2 years after the initial diagnosis despite stable lung disease and normal sACE levels.
  
  
  RESULTS
  Of the patients studied four showed heterochronic cardiac involvement. These patients were all middle-aged women (mean age, 50.5 years) with multiple organ involvement. The time period from the initial diagnosis of sarcoidosis to the onset of cardiac involvement ranged from 3 to 8 years, with a mean duration of 5.2 years. All patients showed fatal conduction abnormalities.
  
  
  CONCLUSIONS
  Middle-aged women with multiple organ involvement of sarcoidosis are at risk of developing cardiac sarcoidosis.
authors.affiliation: Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan. hirosei@za.tnc.ne.jp
authors.forename: Seiichi
authors.initials: S
authors.lastname: Miwa
authors.forename: Takafumi
authors.initials: T
authors.lastname: Suda
authors.forename: Sumihito
authors.initials: S
authors.lastname: Morita
authors.forename: Naoki
authors.initials: N
authors.lastname: Inui
authors.forename: Jun
authors.initials: J
authors.lastname: Sato
authors.forename: Kingo
authors.initials: K
authors.lastname: Chida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D012129:Respiratory Function Tests; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013318:Stroke Volume
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone