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Yoshitomi R, Kobayashi S, Yano Y, Nakashima Y, Fujii S, Nanno T, Ishiguchi H, Fukuda M, Yoshiga Y, Okamura T, Suga K, Kawano R, Yano M. Enhanced oxidative stress and presence of ventricular aneurysm for risk prediction in cardiac sarcoidosis. Heart 2022; 108:429-437. [PMID: 35078868 PMCID: PMC8899481 DOI: 10.1136/heartjnl-2021-320244] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/13/2021] [Indexed: 12/27/2022] Open
Abstract
Objective Sudden cardiac death (SCD) is the major cause of death in cardiac sarcoidosis (CS). We aimed to identify the prognostic markers for sustained ventricular tachycardia (sVT) and SCD in patients with CS. Methods We performed a prospective observational cohort study for patients with CS diagnosed according to the Japanese or Heart Rhythm Society guidelines between June 2008 and March 2020 in our hospital. The primary endpoint was a composite of the first sVT and SCD. The levels of urinary 8-hydroxy-2′-deoxyguanosine (U-8-OHdG), a marker of oxidative DNA damage that reflects the inflammatory activity of CS, other biomarkers, and indices of cardiac function and renal function were measured on admission. Results Eighty-nine consecutive patients with CS were enrolled; 28 patients with no abnormal 18F-fluorodeoxyglucose (18F-FDG) accumulation in the heart were excluded and 61 patients with abnormal 18F-FDG accumulation were followed up for a median of 46 months (IQR: 20–84). During the follow-up period, 15 of 61 patients showed sVT (n=12) or SCD (n=3). A Cox proportional hazard model showed that U-8-OHdG concentration and presence of ventricular aneurysm (VA) were independent predictors of first sVT/SCD. The cut-off U-8-OHdG concentration for predicting first sVT/SCD was 14.9 ng/mg·Cr. Patients with U-8-OHdG concentration ≥14.9 ng/mg·Cr and VA showed a significantly increased risk of sVT/SCD. Conclusions U-8-OHdG and presence of VA were powerful predictors of first sVT/SCD in patients with CS, facilitating the stratification of cardiac events and providing relevant information about the substrates of ventricular tachycardia.
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Affiliation(s)
- Ryosuke Yoshitomi
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Shigeki Kobayashi
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yasutake Yano
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yusuke Nakashima
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Shohei Fujii
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takuma Nanno
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hironori Ishiguchi
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Masakazu Fukuda
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yasuhiro Yoshiga
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takayuki Okamura
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | - Reo Kawano
- Clinical Research Center in Hiroshima, Hiroshima University Hospital, Hiroshima, Japan
| | - Masafumi Yano
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Nanno T, Kobayashi S, Yoshitomi R, Fujii S, Kajii T, Kohno M, Ishiguchi H, Okuda S, Okada M, Suga K, Yano M. Detection of Active Inflammation Status Around Ventricular Aneurysms in Patients With Cardiac Sarcoidosis. Circ J 2019; 83:2494-2504. [PMID: 31631075 DOI: 10.1253/circj.cj-19-0248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Little is known about the pattern of isotope accumulation in the heart on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography in patients with cardiac sarcoidosis (CS) complicated by ventricular aneurysm (VA).Methods and Results:We prospectively enrolled 82 consecutive patients with CS; 54 patients with active CS (presence of abnormal 18F-FDG accumulation in the heart) were subdivided into VA (n=17) and non-VA groups (n=37). Strong 18F-FDG accumulation surrounding the VA and its disappearance in the VA center was observed in all patients with VA, probably because of scar formation at the VA. Peak standardized uptake value was higher around the VA than in the VA center (5.1±2.1 vs. 2.2±0.6, P=0.0003) and the VA center had no 18F-FDG accumulation (VA center: 2.2±0.6 vs. control area: 2.1±0.6, P=0.37). On the other hand, in non-VA patients with LV wall thinning (n=28), 18F-FDG accumulation was significantly high, even in the area of LV wall thinning (LV wall thinning area: 3.1±0.8 vs. control area: 2.0±0.6, P=0.00002). CONCLUSIONS A pattern of strong 18F-FDG accumulation surrounding the VA and its disappearance in the VA center might be characteristic in patients with CS complicated by VA. Careful attention to FDG uptake would further elucidate CS pathophysiology and aid in the early treatment of VA.
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Affiliation(s)
- Takuma Nanno
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Shigeki Kobayashi
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Ryosuke Yoshitomi
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Shohei Fujii
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Toshiro Kajii
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Michiaki Kohno
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Hironori Ishiguchi
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Shinichi Okuda
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Munemasa Okada
- Department of Radiology, Yamaguchi University Graduate School of Medicine
| | | | - Masafumi Yano
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
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Terasaki F, Azuma A, Anzai T, Ishizaka N, Ishida Y, Isobe M, Inomata T, Ishibashi-Ueda H, Eishi Y, Kitakaze M, Kusano K, Sakata Y, Shijubo N, Tsuchida A, Tsutsui H, Nakajima T, Nakatani S, Horii T, Yazaki Y, Yamaguchi E, Yamaguchi T, Ide T, Okamura H, Kato Y, Goya M, Sakakibara M, Soejima K, Nagai T, Nakamura H, Noda T, Hasegawa T, Morita H, Ohe T, Kihara Y, Saito Y, Sugiyama Y, Morimoto SI, Yamashina A. JCS 2016 Guideline on Diagnosis and Treatment of Cardiac Sarcoidosis - Digest Version. Circ J 2019; 83:2329-2388. [PMID: 31597819 DOI: 10.1253/circj.cj-19-0508] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Fumio Terasaki
- Medical Education Center / Department of Cardiology, Osaka Medical College
| | - Arata Azuma
- Department of Pulmonary Medicine, Nippon Medical School
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Nobukazu Ishizaka
- Department of Internal Medicine (III) / Department of Cardiology, Osaka Medical College
| | - Yoshio Ishida
- Department of Internal Medicine, Kaizuka City Hospital
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University
| | - Takayuki Inomata
- Department of Cardiology, Kitasato University Kitasato Institute Hospital
| | | | - Yoshinobu Eishi
- Department of Human Pathology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University
| | - Masafumi Kitakaze
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | | | | | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Takatomo Nakajima
- Division of Cardiology, Saitama Cardiovascular and Respiratory Center
| | - Satoshi Nakatani
- Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine
| | - Taiko Horii
- Department of Cardiovascular Surgery, Kagawa University School of Medicine
| | | | - Etsuro Yamaguchi
- Department of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine
| | | | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Hideo Okamura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Masahiko Goya
- Department of Cardiology, Tokyo Medical and Dental University
| | - Mamoru Sakakibara
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University Faculty of Medicine
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takuya Hasegawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Tohru Ohe
- Department of Cardiology, Sakakibara Heart Institute of Okayama
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Yoshihiko Saito
- Department of Cardiorenal Medicine and Metabolic Disease, Nara Medical University
| | - Yukihiko Sugiyama
- Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University
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Affiliation(s)
- Karen M Marzlin
- Karen M. Marzlin is a cardiology APRN and Business Owner/Author/Educator/Consultant, Key Choice/Cardiovascular Nursing Education Associates, 4565 Venus Rd, Uniontown, OH 44685
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Kaida T, Inomata T, Minami Y, Yazaki M, Fujita T, Iida Y, Ikeda Y, Nabeta T, Ishii S, Naruke T, Maekawa E, Koitabashi T, Ako J. Importance of Early Diagnosis of Cardiac Sarcoidosis in Patients with Complete Atrioventricular Block. Int Heart J 2018; 59:772-778. [DOI: 10.1536/ihj.17-492] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Toyoji Kaida
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Takayuki Inomata
- Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Mayu Yazaki
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Teppei Fujita
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Yuichiro Iida
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Yuki Ikeda
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Takeru Nabeta
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Shunsuke Ishii
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Takashi Naruke
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Toshimi Koitabashi
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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Petrovic M, Buja LM, Kar B, Colnaric J, Damaraju S, Zhao B, Akkanti B, Radovanovic M, Radovancevic R, Loyalka P, Gregoric ID. Cardiac sarcoidosis presenting as arrhythmogenic right ventricular cardiomyopathy/dysplasia with ventricular aneurysms: a case report. Cardiovasc Pathol 2018; 33:1-5. [DOI: 10.1016/j.carpath.2017.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 08/04/2017] [Accepted: 11/02/2017] [Indexed: 11/27/2022] Open
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Abstract
INTRODUCTION Numerous biomarkers have been evaluated for the diagnosis, assessment of disease activity, prognosis, and response to treatment in sarcoidosis. In this report, we discuss the clinical and research utility of several biomarkers used to evaluate sarcoidosis. Areas covered: The sarcoidosis biomarkers discussed include serologic tests, imaging studies, identification of inflammatory cells and genetic analyses. Literature was obtained from medical databases including PubMed and Web of Science. Expert commentary: Most of the biomarkers examined in sarcoidosis are not adequately specific or sensitive to be used in isolation to make clinical decisions. However, several sarcoidosis biomarkers have an important role in the clinical management of sarcoidosis when they are coupled with clinical data including the results of other biomarkers.
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Affiliation(s)
- Amit Chopra
- a Division of Pulmonary and Critical Care Medicine , Albany Medical College , Albany , NY , USA
| | - Alexandros Kalkanis
- b Department of Medicine , Division of Pulmonary and Critical Care Medicine , Athens , Greece
| | - Marc A Judson
- a Division of Pulmonary and Critical Care Medicine , Albany Medical College , Albany , NY , USA
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Pedrotti P, Ammirati E, Bonacina E, Roghi A. Ventricular aneurysms in cardiac sarcoidosis: From physiopathology to surgical treatment through a clinical case presenting with ventricular arrhythmias. Int J Cardiol 2015; 186:294-6. [DOI: 10.1016/j.ijcard.2015.03.256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
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