Outcome of Patients With Cardiac Sarcoidosis Who Received Cardiac Resynchronization Therapy: Comparison With Dilated Cardiomyopathy Patients.

INTRODUCTION

Cardiac resynchronization therapy (CRT) has been shown to be effective for patients with chronic heart failure; however, the efficacy of CRT in patients with cardiac sarcoidosis (CS) has not been established.

METHODS

We compared the outcomes of patients with CS who received CRT to patients with dilated cardiomyopathy (DCM). The incidence of major adverse cerebral and cardiovascular events (MACCE) in 11 consecutive CS patients (8 females; mean age, 66 ± 8.0 years) who received CRT were compared with 29 DCM patients (9 females; mean age, 70 ± 8.9 years).

RESULTS

Females and patients with previous right ventricular pacing were largely included in the comparison of CS and DCM patients (P < 0.05 and P < 0.0001, respectively). During the mean follow-up period (465 ± 383 days for CS and 729 ± 393 days for DCM), MACCE were evident in 9 patients (23%); specifically, 5 CS and 4 DCM patients developed MACCE (45% vs. 14%, P < 0.05), respectively. Kaplan-Meier survival analysis demonstrated that CS patients had a higher prevalence of MACCE than DCM patients (log rank = 6.306, P = 0.0120; and Wilcoxon = 7.1333, P = 0.0076). Based on univariate analysis, the etiology of CS was associated with MACCE.

CONCLUSION

Our results suggest that the long-term outcome of CRT in patients with CS was very poor compared with DCM patients. Thus, caution should be exercised regarding the indication of CRT in patients with CS.