Journal of cardiology · 2025
Prognostic value of the clinical phenotype in patients with cardiac sarcoidosis: SARCO phenotype.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Miyahara Daisuke, Kida Keisuke, Nabeta Takeru, Yoshioka Kenji, Naruse Yoshihisa, Taniguchi Tatsunori, Tanaka Hidekazu, Morimoto Ryota, Baba Yuichi, Kitai Takeshi, Matsue Yuya, Akashi Yoshihiro J
Аннотация
BACKGROUND: Sarcoidosis, a multisystem granulomatous disease, can affect any organ and has various clinical presentations. Patients with sarcoidosis with cardiac involvement have a poorer prognosis than those without cardiac involvement. The prognostic value of the clinical manifestations at the time of cardiac sarcoidosis (CS) diagnosis remains unknown.
METHODS: This secondary analysis of the ILLUMINATE-CS study evaluated the clinical characteristics and prognoses of patients with CS. The primary endpoint was a composite of all-cause death, hospitalization for heart failure (HF), and documented fatal ventricular arrhythmia events.
RESULTS: We analyzed the data of 502 patients (mean age, 61.5 years; male, 36.1 %) diagnosed with CS and classified them into four clinical phenotypes (subclinical, arrhythmia, congestive heart failure, and overlapping phenotypes) based on the clinical manifestations at CS diagnosis. Over a median follow-up period of 1045 days, 145 primary endpoints were observed. For the subclinical phenotype, the 10-year estimated primary endpoint event rate was 20.8 %, whereas the corresponding rates in other clinical phenotypes were significantly higher (log-rank test, p < 0.001 for all comparisons). The rate of fatal ventricular arrhythmia events was also significantly lower in the subclinical phenotype than in other clinical phenotypes (log-rank test, p = 0.011, 0.041, and 0.002, respectively). The event rate of hospitalization for HF was significantly higher in the congestive HF and overlapping phenotypes than in the subclinical and arrhythmia phenotypes (log-rank test, p < 0.001 for all comparisons).
CONCLUSIONS: The clinical phenotype of CS is a useful prognostic indicator. The characteristics of clinical events differed for each clinical phenotype. Tailored management strategies should be implemented for each clinical phenotype.
METHODS: This secondary analysis of the ILLUMINATE-CS study evaluated the clinical characteristics and prognoses of patients with CS. The primary endpoint was a composite of all-cause death, hospitalization for heart failure (HF), and documented fatal ventricular arrhythmia events.
RESULTS: We analyzed the data of 502 patients (mean age, 61.5 years; male, 36.1 %) diagnosed with CS and classified them into four clinical phenotypes (subclinical, arrhythmia, congestive heart failure, and overlapping phenotypes) based on the clinical manifestations at CS diagnosis. Over a median follow-up period of 1045 days, 145 primary endpoints were observed. For the subclinical phenotype, the 10-year estimated primary endpoint event rate was 20.8 %, whereas the corresponding rates in other clinical phenotypes were significantly higher (log-rank test, p < 0.001 for all comparisons). The rate of fatal ventricular arrhythmia events was also significantly lower in the subclinical phenotype than in other clinical phenotypes (log-rank test, p = 0.011, 0.041, and 0.002, respectively). The event rate of hospitalization for HF was significantly higher in the congestive HF and overlapping phenotypes than in the subclinical and arrhythmia phenotypes (log-rank test, p < 0.001 for all comparisons).
CONCLUSIONS: The clinical phenotype of CS is a useful prognostic indicator. The characteristics of clinical events differed for each clinical phenotype. Tailored management strategies should be implemented for each clinical phenotype.