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Patterns of myocardial inflammation and scarring in sarcoidosis as assessed by cardiovascular magnetic resonance
  1. J Schulz-Menger1,
  2. R Wassmuth1,
  3. H Abdel-Aty1,*,
  4. I Siegel1,
  5. A Franke2,
  6. R Dietz1,
  7. M G Friedrich1,*
  1. 1Franz-Volhard-Klinik, Helios-Klinikum Berlin, Kardiologie, Charité Campus Berlin-Buch, Humboldt-Universität zu Berlin, Berlin, Germany
  2. 2Fachkrankenhaus für Lungenheilkunde und Thoraxchirurgie, Berlin-Buch, Germany
  1. Correspondence to:
    Dr Jeanette Schulz-Menger
    Franz-Volhard-Klinik, Charité Campus Buch, Wiltbergstrasse 50, D-13125 Berlin, Germany; schulzmenger{at}fvk-berlin.de

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Sarcoidosis is a multisystemic disease. Cardiac involvement has a strong impact on the patient’s prognosis but is difficult to detect in vivo. This is reflected by the high rate of unexpected cardiac sarcoidosis in postmortem studies. In a study of patients with necropsy proven cardiac sarcoidosis, it was established or suspected before death in only 45%, with cardiac involvement being fatal in 67%.1 Cardiac sarcoidosis is mostly identified by impaired systolic left ventricular (LV) function, a feature of more advanced disease.

Cardiovascular magnetic resonance (CMR) detects tissue inflammation and fibrosis. The focus of our study was to identify cardiac tissue changes in patients with systemic sarcoidosis by using CMR.

PATIENTS AND METHODS

Between 1999 and 2003, we studied 31 patients with proven systemic sarcoidosis (mean (SD) age 46 (2) years; 19 men). Twelve patients (48 (4) years; 10 men) had evidence for cardiac involvement as defined by typical symptoms and documented arrhythmias. In eight patients with chest pain, risk factors for coronary artery disease, or age above 30 years, coronary artery disease was excluded by coronary angiography. The remaining four patients were three men and one woman (25, 30, 29, and 30 years old, respectively). All of them were non-smokers, had a normal serum lipid profile, and …

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