Cardiac Sarcoidosis: When and How to Treat Inflammation

Gerard T Giblin; Laura Murphy; Garrick C Stewart; Akshay S Desai; Marcelo F Di Carli; Ron Blankstein; Michael M Givertz; Usha B Tedrow; William H Sauer; Gary M Hunninghake; Paul F Dellaripa; Sanjay Divakaran; Neal K Lakdawala

doi:10.15420/cfr.2021.16

Cardiac Failure Review (Nov 2021)

Cardiac Sarcoidosis: When and How to Treat Inflammation

Gerard T Giblin,
Laura Murphy,
Garrick C Stewart,
Akshay S Desai,
Marcelo F Di Carli,
Ron Blankstein,
Michael M Givertz,
Usha B Tedrow,
William H Sauer,
Gary M Hunninghake,
Paul F Dellaripa,
Sanjay Divakaran,
Neal K Lakdawala

Affiliations

Gerard T Giblin: Center for Advanced Heart Disease, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Laura Murphy: Cardiovascular Imaging Program and Departments of Medicine and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Garrick C Stewart: Center for Advanced Heart Disease, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Akshay S Desai: Center for Advanced Heart Disease, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Marcelo F Di Carli: Cardiovascular Imaging Program and Departments of Medicine and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Ron Blankstein: Cardiovascular Imaging Program and Departments of Medicine and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Michael M Givertz: Center for Advanced Heart Disease, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Usha B Tedrow: Cardiac Arrhythmia Service, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
William H Sauer: Cardiac Arrhythmia Service, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Gary M Hunninghake: Interstitial Lung Disease Program, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Paul F Dellaripa: Interstitial Lung Disease Program, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Sanjay Divakaran: Center for Advanced Heart Disease, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
Neal K Lakdawala: Center for Advanced Heart Disease, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US

DOI: https://doi.org/10.15420/cfr.2021.16
Journal volume & issue: Vol. 7

Abstract

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Sarcoidosis is a complex, multisystem inflammatory disease with a heterogeneous clinical spectrum. Approximately 25% of patients with systemic sarcoidosis will have cardiac involvement that portends a poorer outcome. The diagnosis, particularly of isolated cardiac sarcoidosis, can be challenging. A paucity of randomised data exist on who, when and how to treat myocardial inflammation in cardiac sarcoidosis. Despite this, corticosteroids continue to be the mainstay of therapy for the inflammatory phase, with an evolving role for steroid-sparing and biological agents. This review explores the immunopathogenesis of inflammation in sarcoidosis, current evidence-based treatment indications and commonly used immunosuppression agents. It explores a multidisciplinary treatment and monitoring approach to myocardial inflammation and outlines current gaps in our understanding of this condition, emerging research and future directions in this field.

Published in Cardiac Failure Review

ISSN: 2057-7540 (Print); 2057-7559 (Online)
Publisher: Radcliffe Medical Media
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.cfrjournal.com/

About the journal