Sudden death in cardiac sarcoidosis: an analysis of nationwide clinical and cause-of-death registries

被引：116

作者：

Ekstrom, Kaj ^{[1
,2
]}

Lehtonen, Jukka ^{[1
,2
]}

Nordenswan, Hanna-Kaisa ^{[1
,2
]}

Mayranpaa, Mikko, I ^{[3
,4
]}

Raisanen-Sokolowski, Anne ^{[3
,4
]}

Kandolin, Riina ^{[1
,2
]}

Simonen, Piia ^{[1
,2
]}

Pietila-Effati, Paivi ^{[5
]}

Alatalo, Aleksi ^{[6
]}

Utriainen, Seppo ^{[7
]}

Rissanen, Tuomas T. ^{[8
]}

Haataja, Petri ^{[9
]}

Kokkonen, Jorma ^{[10
]}

Vihinen, Tapani ^{[11
]}

Miettinen, Heikki ^{[12
]}

Kaikkonen, Kari ^{[13
,14
]}

Kerola, Tuomas ^{[15
]}

Kupari, Markku ^{[1
,2
]}

机构：

[1] Univ Helsinki, Heart & Lung Ctr, Stenbackinkatu 9, Helsinki 00029, Finland

[2] Helsinki Univ Hosp, Stenbackinkatu 9, Helsinki 00029, Finland

[3] Univ Helsinki, Pathol, Haartmaninkatu 3, Helsinki 00014, Finland

[4] Helsinki Univ Hosp, Haartmaninkatu 3, Helsinki 00014, Finland

[5] Vaasa Cent Hosp, Dept Cardiol, Hietalandenkatu 2-4, Vaasa 65130, Finland

[6] Hosp Dist South Ostrobothnia, Intervent Cardiac Unit, Seinajoki Cent Hosp, Hanneksenrinne 7, Seinajoki 60220, Finland

[7] South Karelia Cent Hosp, Dept Internal Med, Valto Kakelan Katu 1, Lappeenranta 53130, Finland

[8] North Karelia Cent Hosp, Heart Ctr, Tikkamaentie 16, Joensuu 80210, Finland

[9] Tays Heart Hosp, Dept Cardiol, Ensitie 4, Tampere 33560, Finland

[10] Cent Finland Cent Hosp, Dept Internal Med, Keskussairaalantie 19, Jyvaskyla 40620, Finland

[11] Turku Univ Hosp, Heart Ctr, Hameentie 11, Turku 20521, Finland

[12] Kuopio Univ Hosp, Heart Ctr, Puijonlaaksontie 2, Kuopio 70029, Finland

[13] Univ Hosp Oulu, Res Unit Internal Med, Kajaanintie 50, Oulu 90014, Finland

[14] Univ Oulu, Kajaanintie 50, Oulu 90014, Finland

[15] Paijat Hame Cent Hosp, Dept Internal Med, Keskussairaalankatu 7, Lahti 15850, Finland

来源：

EUROPEAN HEART JOURNAL | 2019年 / 40卷 / 37期

关键词：

Cardiac sarcoidosis; Sudden cardiac death; DIAGNOSIS; EPIDEMIOLOGY; HEART;

D O I：

10.1093/eurheartj/ehz428

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims The present study was done to assess the role of sudden cardiac death (SCD) among the presenting manifestations of and fatalities from cardiac sarcoidosis (CS). Methods and results We analysed altogether 351 cases of CS presenting from year 1998 through 2015 in Finland. There were 262 patients with a clinical diagnosis and treatment of CS, 27 patients with an initial lifetime diagnosis of giant cell myocarditis that was later converted to CS, and 62 cases detected at autopsy and identified by screening >820 000 death certificates from the national cause-of-death registry. The total case series comprised 253 females and 98 males aged on average 52 years at presentation. High-grade atrioventricular block was the most common first sign of CS (n = 147, 42%) followed by heart failure (n = 58, 17%), unexpected fatal (n = 38) or aborted (n = 12) SCD (14%), and sustained ventricular tachycardia (n = 48, 14%). Severe coronary artery disease was found at autopsy concomitant with CS in four of the 38 cases presenting with fatal SCD. Of all deaths recorded till the end of 2015, 64% (n = 54/84) were unexpected SCDs from CS that had either been silent during life or defied all attempts at diagnosis. The Kaplan-Meier estimate (95% CI) of survival from symptom onset was 85% (80-90%) at 5 years and 76% (68-84%) at 10 years. Conclusion Together fatal and aborted SCD constitute 14% of the presenting manifestations of CS. Nearly two-thirds of all fatalities from CS are caused by undiagnosed granulomas in the heart.

引用

页码：3121 / 3128

页数：8

共 24 条

[11] Magnetic Resonance Imaging as a Predictor of Survival Free of Life-Threatening Arrhythmias and Transplantation in Cardiac Sarcoidosis [J].