Title :

Sarcoidosis diagnosed on granulomas in the explanted heart after transplantation: results of a french nationwide study

Author(s) :

Chazal, Thibaud [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Varnous, Shaida [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Guihaire, Julien [Auteur]
Hôpital Marie-Lannelongue
Goeminne, Celine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Launay, David [Auteur]
Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France [CeRAINO]
Boignard, Aude [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Vermes, Emmanuelle [Auteur]
CHU Trousseau [Tours]
Dorent, Richard [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Camilleri, Lionel [Auteur]

Lelong, Bernard [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Epailly, Éric [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Lebreton, Guillaume [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Waintraub, Xavier [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Cluzel, Philippe [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Maksud, Philippe [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Fouret, Pierre [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Leprince, Pascal [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Grenier, Philippe [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Amoura, Zahir [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Cohen Aubart, Fleur [Auteur]
CHU Pitié-Salpêtrière [AP-HP]

Journal title :

International Journal of Cardiology

Abbreviated title :

Int. J. Cardiol.

Publication date :

2020-01-17

ISSN :

1874-1754

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Cardiac sarcoidosis (CS) is a challenging diagnosis. Patients may progress to end-stage congestive heart failure and require cardiac transplantation without ever having been diagnosed. Characteristics and ...
Show more >BACKGROUND: Cardiac sarcoidosis (CS) is a challenging diagnosis. Patients may progress to end-stage congestive heart failure and require cardiac transplantation without ever having been diagnosed. Characteristics and outcomes of patients with granulomas in the explanted hearts are unknown. METHODS: All French heart transplantation centers were contacted to participate in the study. Each center searched through local databases for the cases of non-caseating granuloma in the explanted hearts between 2000 and 2017. Data before and after transplantation were recorded from medical charts. Survival of CS and all- cause heart transplantation patients were compared. RESULTS: Fifteen patients (10 men, 5 women) received a diagnosis of CS based on pathologic data of the explanted heart and were recruited for the study. All patients were diagnosed as non-ischemic dilated or hypertrophic cardiomyopathy and presented congestive heart failure. Eight patients (53%) had ventricular rhythm disturbances, and 3 (20%) a complete heart block. Ten out of 13 patients (77%) had extracardiac radiological signs compatible with sarcoidosis on chest computed tomography (CT) scans. One patient died 3 months after transplantation from infectious complications. The 14 remaining patients were still alive at the end of the study (median follow-up of 28.8 months). One patient had a second heart transplantation 5 years later because of chronic allograft vasculopathy. One patient presented a relapse of CS confirmed by myocardial biopsies 9 years after transplantation, requiring an escalation of immunosuppressive therapy. CONCLUSIONS: CS may be undiagnosed before heart transplantation. In 77% of cases, sarcoidosis could have been detected before transplantation with non-invasive imaging techniques.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2021-07-06T12:45:15Z
2024-02-02T10:27:10Z