title: Effect of corticosteroid therapy on ventricular arrhythmias in patients with cardiac sarcoidosis.
abstract: BACKGROUND
  Ventricular arrhythmias are one of the main causes of sudden death in cardiac sarcoidosis (CS). Little is known about the efficacy of corticosteroid therapy for ventricular arrhythmias in CS.
  
  
  METHODS
  Thirty-one CS patients presenting premature ventricular contractions (PVCs, ≥300/day) were investigated. Fourteen patients had nonsustained ventricular tachycardia (NSVT). All of patients were treated with corticosteroid, and the initial dosage is 30 mg/day of prednisone, which was tapered over a period of 6 months to a maintenance dosage of 10 mg/day. Twenty-four hour Holter monitoring, signal averaged electrocardiography (SAECG), echocardiography, gallium-67 scintigraphy, serum angiotensin converting enzyme (ACE) and plasma B-type natriuretic peptide (BNP) concentrations were assessed before and after corticosteroid therapy.
  
  
  RESULTS
  As a whole, there were no significant differences in the number of PVCs and in the prevalence of NSVT before and after steroid therapy. However, the less advanced LV dysfunction patients (EF ≥ 35%, n = 17) showed significant reduction in the number of PVCs (from 1820 ± 2969 to 742 ± 1425, P = 0.048) and in the prevalence of NSVT (from 41 to 6%, p = 0.039). Late potentials on SAECG were abolished in 3 patients. The less advanced LV dysfunction group showed a significantly higher prevalence of gallium-67 uptake compared with the advanced LV dysfunction group (EF < 35 %, n = 14). In the advanced LV dysfunction patients, there were no significant differences in these parameters.
  
  
  CONCLUSIONS
  Corticosteroid therapy may be effective for ventricular arrhythmias in the early stage, but less effective in the late stage.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan. yodo@nms.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Yodogawa
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ohara
authors.forename: Hideo
authors.initials: H
authors.lastname: Takayama
authors.forename: Takao
authors.initials: T
authors.lastname: Katoh
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers