Cardiac sarcoidosis (CS) is a form of inflammatory cardiomyopathy associated with significant clinical complications such as high-degree atrioventricular block, ventricular tachycardia, and heart failure as well as sudden cardiac death. It is therefore important to provide an expert consensus statement summarizing the role of different available diagnostic tools and emphasizing the importance of a multidisciplinary approach. By integrating clinical information and the results of diagnostic tests, an accurate, validated, and timely diagnosis can be made, while alternative diagnoses can be reasonably excluded. This clinical expert consensus statement reviews the evidence on the management of different CS manifestations and provides advice to practicing clinicians in the field on the role of immunosuppression and the treatment of cardiac complications based on limited published data and the experience of international CS experts. The monitoring and risk stratification of patients with CS is also covered, while controversies and future research needs are explored.

• MeSH
• imunosupresiva terapeutické užití   MeSH
• kardiomyopatie * diagnóza   terapie   MeSH
• lidé MeSH
• náhlá srdeční smrt prevence a kontrola   etiologie   MeSH
• sarkoidóza * diagnóza   terapie   komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

A wide range of viral agents is associated with the development of acute myocarditis and its possible chronic sequela, dilated cardiomyopathy (DCM). There is also increasing evidence that Borrelia burgdorferi (Bb) is associated with DCM in endemic regions for Bb infection. This study sought to use electron microscopy to prospectively analyze the presence of viruses and Bb within the myocardium of 40 subjects with preserved left ventricular (LV) ejection fraction and 40 patients with new-onset unexplained DCM during the same time period. Virus particles were found within the myocardium of 23 subjects (58%) of both cohorts studied, yet there was no statistically significant difference in virus family presence between those with DCM versus those with preserved LV systolic function. In contrast, Bb was detected only in those subjects with DCM (0 versus 5 subjects; p ˂ 0.05). Polymerase chain reaction was performed on samples from patients who were positive for Bb according to electron microscopy, and Bb was confirmed in 4 out of 5 individuals. Our results demonstrate that the prevalence of viral particles does not differ between subjects with preserved LV systolic function versus those with DCM and therefore suggests that the mere presence of a viral agent within the myocardium is not sufficient to establish a clear link with the development of DCM. In contrast, the presence of Bb was found only within myocardial samples of patients with DCM; this finding supports the idea of a causal relationship between Bb infection and DCM development.

• MeSH
• antivirové látky škodlivé účinky   terapeutické užití   MeSH
• Borrelia burgdorferi genetika   izolace a purifikace   fyziologie   ultrastruktura   MeSH
• dilatační kardiomyopatie mikrobiologie   patofyziologie   virologie   MeSH
• elektronová mikroskopie MeSH
• funkce levé komory srdeční MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymeská nemoc klasifikace   mikrobiologie   patofyziologie   MeSH
• myokard ultrastruktura   MeSH
• prospektivní studie MeSH
• senioři MeSH
• srdce mikrobiologie   patofyziologie   virologie   MeSH
• virové nemoci komplikace   farmakoterapie   virologie   MeSH
• viry klasifikace   genetika   izolace a purifikace   ultrastruktura   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH