Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone☆
Section snippets
Patient selection
Patients who were diagnosed with cardiac sarcoidosis at our institution and collaborating hospitals between 1984 and 1996 were analyzed retrospectively. Clinical details and follow-up information for patients from collaborating centers were obtained by questionnaire, and if needed, by telephone or letter. Clinical data included electrocardiograms, echocardiograms, radionuclide examinations, hemodynamics, contrast left ventriculograms, and endomyocardial biopsies. We obtained records concerning
Clinical characteristics of the study population
Age and sex distribution of all patients is shown in Figure 1. Cardiac sarcoidosis occurred most frequently in middle-aged women. Patient characteristics are listed in Table 1. Subjects with autopsy-proven sarcoidosis had significantly reduced systolic performance, severe heart failure symptoms, a higher incidence of complete atrioventricular block and sustained ventricular tachycardia, and an enlarged left ventricle compared with the steroid-treated patients. During follow-up, 40 died from
Recent clinical profile in cardiac sarcoidosis
In the present study, cardiac sarcoidosis most frequently occurred in women between 50 and 65 years of age. This same tendency has been noted in other Japanese studies.11, 12 In Western countries, there is no definite male or female predominance in the occurrence of the syndrome and differences in mean age; cardiac involvement in sarcoidosis is more predominant among young persons.3, 13, 14, 15 A racial difference should be considered in cardiac sarcoidosis.
In a previous report by Roberts et al,
Acknowledgements
The investigators thank the physicians at the following institutions who provides patient data: Gifu University: Hisayoshi Fujiwara, Kenji Nagashima, Hiroyasu Itoh; Hokaido University: Nagara Tamaki; Kyoto University: Masatoshi Fujita; Komatsujima Red Cross Hospital: Yoshikazu Hiasa; Keio University: Satoshi Ogawa; Asahikawa Medical College: Kenjiro Kikuchi; Tenri Yorozu Sodanshyo Hospital: Hiromitsu Gen; Kanazawa Medical University: Eiji Murakami; Toho University Ohashi Hospital: Michiro
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This study was supported in part by a research grant from the Intractable Disease Division, Public Health Bureau, Ministry of Health Welfare, Tokyo, Japan.