title: Prospective study of cardiac sarcoid mimicking arrhythmogenic right ventricular dysplasia.
abstract: BACKGROUND
  Case studies indicate that cardiac sarcoid may mimic the clinical presentation of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C); however, the incidence and clinical predictors to diagnose cardiac sarcoid in patients who meet International Task Force criteria for ARVD/C are unknown.
  
  
  RESULTS
  Patients referred for evaluation of left bundle branch block (LBBB)-type ventricular arrhythmia and suspected ARVD/C were prospectively evaluated by a standardized protocol including right ventricle (RV) cineangiography-guided myocardial biopsy. Sixteen patients had definite ARVD/C and four had probable ARVD/C. Three patients were found to have noncaseating granulomas on biopsy consistent with sarcoid. Age, systemic symptoms, findings on chest X-ray or magnetic resonance imaging (MRI), type of ventricular arrhythmia, RV function, ECG abnormalities, and the presence or duration of late potentials did not discriminate between sarcoid and ARVD/C. Left ventricular dysfunction (ejection fraction <50%) was present in 3/3 patients with cardiac sarcoid, but only 2/17 remaining patients with definite or probable ARVD/C (P = 0.01).
  
  
  CONCLUSIONS
  In this prospective study of consecutive patients with suspected ARVD/C evaluated by a standard protocol including biopsy, the incidence of cardiac sarcoid was surprisingly high (15%). Clinical features, with the exception of left ventricular dysfunction and histological findings, did not discriminate between the two entities.
authors.affiliation: Cardiovascular Institute, Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors.forename: Smit C
authors.initials: SC
authors.lastname: Vasaiwala
authors.forename: Cynthia
authors.initials: C
authors.lastname: Finn
authors.forename: Jeanne
authors.initials: J
authors.lastname: Delpriore
authors.forename: Fred
authors.initials: F
authors.lastname: Leya
authors.forename: James
authors.initials: J
authors.lastname: Gagermeier
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Akar
authors.forename: Peter
authors.initials: P
authors.lastname: Santucci
authors.forename: Khaled
authors.initials: K
authors.lastname: Dajani
authors.forename: Davide
authors.initials: D
authors.lastname: Bova
authors.forename: Maria M
authors.initials: MM
authors.lastname: Picken
authors.forename: Cristina
authors.initials: C
authors.lastname: Basso
authors.forename: Frank
authors.initials: F
authors.lastname: Marcus
authors.forename: David J
authors.initials: DJ
authors.lastname: Wilber
mesh_terms: D000293:Adolescent; D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000473:pathology*; D009202:Cardiomyopathies / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D012507:Sarcoidosis / Q000473:pathology*; D055815:Young Adult