Modern approaches to the diagnosis and treatment of cardiac sarcoidosis: results of a cohort study

Aim . To analyze clinical and paraclinical data in patients with documented cardiac sarcoidosis, outlining the key points of diagnosis selection optimal treatment. Material methods For period from 2016 to 2021, 63 (50,4±14,1 years) were included cohort study on negotiability. Based a standard examination, 15 (41±13 years old) selected, who continued examination confirm sarcoidosis. Contrast-enhanced magnetic resonance imaging (MRI) was performed 10 patients, while endomyocardial biopsy 7 patients. All underwent 18F-fluorodeoxyglucose positron emission tomography (PET). Results The most common (53%) electrocardiographic abnormality right bundle branch block. Ventricular arrhythmias high-grade atrioventricular block recorded mainly activity. Regional contractility disorders predominantly detected fibrosis. Delayed contrast enhancement according MRI intramurally interventricular septum subepicardial area left ventricular (LV) lateral wall. When analyzing PET results, we found predominant radiopharmaceutical accumulation (56%), (44%) anterior (33%) LV walls. There no significant improvement global against background immunosuppressive therapy, especially reduced ejection fraction: initially 49,2±10,1% vs 46,9±14,9% during therapy (p=0,658). Conclusion A certain apprehensive attitude doctor adherence algorithm for early sarcoidosis allows minimizing risks fatal cardiovascular events. On contrary, case late diagnosis, even use aggressive does not lead an myocardial contractility, fibrosis zones can cause life-threatening bradyarrhythmias arrhythmias.