scholarly journals Short- and long-term outcomes after heart transplantation in cardiac sarcoidosis and giant-cell myocarditis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Emanuele Bobbio ◽  
Marie Björkenstam ◽  
Bright I. Nwaru ◽  
Francesco Giallauria ◽  
Eva Hessman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Giant Cell ◽  
Cardiac Sarcoidosis ◽  
Therapeutic Option ◽  
Meta Analysis ◽  
Disease Recurrence ◽  
Acute Cellular Rejection ◽  
Giant Cell Myocarditis ◽  
Cellular Rejection

AbstractHeart transplantation (HTx) is a valid therapeutic option for end-stage heart failure secondary to cardiac sarcoidosis (CS) or giant-cell myocarditis (GCM). However, post-HTx outcomes in patients with inflammatory cardiomyopathy (ICM) have been poorly investigated. We searched PubMed, Scopus, Science Citation Index, EMBASE, and Google Scholar, screened the gray literature, and contacted experts in the field. We included studies comparing post-HTx survival, acute cellular rejection, and disease recurrence in patients with and without ICM. Data were synthesized by a random‐effects meta‐analysis. We screened 11,933 articles, of which 14 were considered eligible. In a pooled analysis, post-HTx survival was higher in CS than non-CS patients after 1 year (risk ratio [RR] 0.88, 95% confidence interval [CI] 0.60–1.17; I2 = 0%) and 5 years (RR 0.72, 95% CI 0.52–0.91; I2 = 0%), but statistically significant only after 5 years. During the first-year post-HTx, the risk of acute cellular rejection was similar for patients with and without CS, but after 5 years, it was lower in those with CS (RR 0.38, 95% CI 0.03–0.72; I2 = 0%). No difference in post-HTx survival was observed between patients with and without GCM after 1 year (RR 1.16, 95% CI 0.05–2.28; I2 = 0%) or 5 years (RR 0.98, 95% CI 0.42–1.54; I2 = 0%). During post-HTx follow-up, recurrence of CS and GCM occurred in 5% and 8% of patients, respectively. Post-HTx outcomes in patients with CS and GCM are comparable with cardiac recipients with other heart failure etiologies. Patients with ICM should not be disqualified from HTx. Graphic abstract

Rejection in heart transplantation for cardiac sarcoidosis mimicking idiopathic giant cell myocarditis

2019 ◽  
Vol 20 (4) ◽  
pp. 264-266 ◽  
Author(s):  
Concetta Di Nora ◽  
Daniela Miani ◽  
Sandro Sponga ◽  
Ugolino Livi
Keyword(s):  
Heart Transplantation ◽  
Giant Cell ◽  
Cardiac Sarcoidosis ◽  
Giant Cell Myocarditis

scholarly journals Myocarditis and Inflammatory Cardiomyopathy

2021 ◽  
Author(s):  
Emanuele Bobbio ◽  
Kristjan Karason
Keyword(s):  
Heart Failure ◽  
Giant Cell ◽  
Cardiac Sarcoidosis ◽  
Circulatory Support ◽  
Inflammatory Cardiomyopathy ◽  
Giant Cell Myocarditis ◽  
Lymphocytic Myocarditis ◽  
Randomized Intervention ◽  
Eosinophilic Myocarditis ◽  
Intervention Trials

Activation of the inflammatory system occurs in most patients with advanced heart failure, regardless of etiology, and contributes to the pathophysiological milieu and the progression of the disease. The term inflammatory cardiomyopathy (ICM) refers to a group of disorders for which an acute or chronic myocardial inflammation is the central cause of abnormal cardiac structure or impaired cardiac function. The most common cause of inflammatory cardiomyopathy is lymphocytic myocarditis, which is most usually triggered by a viral infection, and occasionally by other infectious agents. Rare causes of specific inflammatory cardiomyopathies include cardiac sarcoidosis, giant cell myocarditis and eosinophilic myocarditis. Inflammatory cardiomyopathy can also occur in connection with autoimmune inflammatory diseases. Typical manifestations of inflammatory cardiomyopathy include chest pain, heart failure, and arrhythmias, but these symptoms and signs are unspecific. Although non-invasive diagnostic methods are emerging, the gold standard of diagnosis is the histological examination of an endomyocardial biopsy. Owing to the invasive nature of this technique and a modest diagnostic sensitivity, its use is limited. Therefore, the identification of inflammatory cardiomyopathy is elusive and the true incidence of the condition remains unknown. In most cases of lymphocytic myocarditis, recovery occurs within a few weeks following supportive treatment. In patients with cardiac sarcoidosis, giant cell myocarditis or eosinophilic myocarditis the use of immunosuppressive treatment is recommended, as is the case in myocarditis associated with autoimmune disorders. Such interventions may also have beneficial effects in chronic viral myocarditis once the virus has been cleared. In severe cases, treatment with mechanical circulatory support and/or heart transplantation may be required. Randomized intervention trials including antiviral, immunomodulating, or immunosuppressive agents are lacking. Similarly, new molecular-based methods and therapies tailored to specific pathogeneses have a potential to improve diagnosis and outcomes in patients with inflammatory cardiomyopathy. Still, such techniques and interventions are to be evaluated in adequate randomized controlled studies.

scholarly journals Correction to: Usefulness of speckle tracking echocardiography and biomarkers for detecting acute cellular rejection after heart transplantation

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Cecilia Beatriz Bittencourt Viana Cruz ◽  
Ludhmila A. Hajjar ◽  
Fernando Bacal ◽  
Marco S. Lofrano-Alves ◽  
Márcio S. M. Lima ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Acute Cellular Rejection ◽  
Cellular Rejection

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals 5697Heart transplantation in giant cell myocarditis and cardiac sarcoidosis

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
D. Velikanova ◽  
J. Lehtonen ◽  
P. Simonen ◽  
M. Kupari
Keyword(s):  
Giant Cell ◽  
Cardiac Sarcoidosis ◽  
Giant Cell Myocarditis

scholarly journals P2576Comparison of giant cell myocarditis and cardiac sarcoidosis in a nationwide registry

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
H.-K. Nordenswan ◽  
K. Ekstrom ◽  
J. Lehtonen ◽  
M. Kupari ◽  
Keyword(s):  
Giant Cell ◽  
Cardiac Sarcoidosis ◽  
Giant Cell Myocarditis ◽  
Nationwide Registry
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