loading page

Impact of Corticosteroid Use on the Clinical Response and Prognosis in Patients with Cardiac Sarcoidosis who Underwent an Upgrade to Cardiac Resynchronization Therapy
  • +13
  • Yuya Suzuki,
  • Mitsuru Takami,
  • Koji Fukuzawa,
  • kunihiko kiuchi,
  • Akira Shimane,
  • jun sakai,
  • Toshihiro Nakamura,
  • atsusuke yatomi,
  • Yusuke Sonoda,
  • Hiroyuki Takahara,
  • Kazutaka Nakasone,
  • Kyoko Yamamoto,
  • Kenichi Tani,
  • Hidehiro Iwai,
  • Yusuke Nakanishi,
  • Ken-ichi Hirata
Yuya Suzuki
Kobe University Graduate School of Medicine
Author Profile
Mitsuru Takami
Kobe University Graduate School of Medicine

Corresponding Author:[email protected]

Author Profile
Koji Fukuzawa
Kobe University Graduate School of Medicine
Author Profile
kunihiko kiuchi
Kobe University Graduate School of Medicine
Author Profile
Akira Shimane
Hyogo Brain and Heart Center
Author Profile
jun sakai
Kobe University Graduate School of Medicine
Author Profile
Toshihiro Nakamura
Kobe University Graduate School of Medicine
Author Profile
atsusuke yatomi
Kobe University Graduate School of Medicine
Author Profile
Yusuke Sonoda
Kobe University Graduate School of Medicine
Author Profile
Hiroyuki Takahara
Kobe University Graduate School of Medicine
Author Profile
Kazutaka Nakasone
Kobe University Graduate School of Medicine
Author Profile
Kyoko Yamamoto
Kobe University Graduate School of Medicine
Author Profile
Kenichi Tani
Kobe University Graduate School of Medicine
Author Profile
Hidehiro Iwai
Kobe University Graduate School of Medicine
Author Profile
Yusuke Nakanishi
Kobe University Graduate School of Medicine
Author Profile
Ken-ichi Hirata
Kobe University Graduate School of Medicine
Author Profile

Abstract

Aims Corticosteroids are widely used in patients with cardiac sarcoidosis (CS). In addition, upgrading to cardiac resynchronization therapy (CRT) is sometimes needed. This study aimed to investigate the impact of corticosteroid use on the clinical outcomes following CRT upgrades. Methods A total of 48 consecutive patients with non-ischemic cardiomyopathies who underwent CRT upgrades were retrospectively reviewed and divided into three groups: group 1 included CS patients taking corticosteroids before the CRT upgrade (n = 7), group 2, CS patients not taking corticosteroids before the CRT upgrade (n = 10), and group 3, non-CS patients (n = 31). The echocardiographic response, heart failure hospitalizations, and cardiovascular deaths were evaluated. Results The baseline characteristics during CRT upgrades exhibited no significant differences in the echocardiographic data between the three groups. After the CRT upgrade, responses regarding the ejection fraction (EF) and end-systolic volume (ESV) were significantly lower in CS patients than non-CS patients (ΔEF: group 1, 6.7% vs. group 2, 7.7% vs. group 3, 13.6%; p=0.039, ΔESV: 3.0 mL vs. -12.7 mL vs. -37.2 mL; p = 0.008). The rate of an echocardiographic response was lowest in group 1 (29%). There were, however, no significant differences in the cumulative freedom from a composite outcome among the three groups (p = 0.19). No cardiovascular deaths occurred in group 1. Conclusion CS patients taking corticosteroids before the CRT upgrade had lower echocardiographic responses but higher freedom rates from a composite endpoint. The timing of corticosteroid use would affect the clinical course following a CRT upgrade.