ARYA Atherosclerosis Journal

Cardiac Sarcoidosis: A Contemporary Concept of Forgotten Granulomatosis

Document Type : Review Article

Authors

Ashot Avagimyan 1
Lusine Mkrtchyan 2
Tamara Bairamyan 3
Zinaida Jndoyan 4
Grizelda Navasardyan 5
Knarik Ginosyan 6
Anahit Aznauryan 7
Karmen Sahakyan 7
Alexey Ionov 8
Ivan Pavluchenko 9
Liana Gogiashvili 10
Davood Shafie 11
Nizal Sarrafzadegan 12

1 Department of Anatomical Pathology and Clinical Morphology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia

2 Department of Cardiology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia

3 Department of Rheumatology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia

4 Internal Deceases Propaedeutic Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia

5 Department of Pathophysiology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia

6 Rheumatology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia

7 Histology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia

8 Internal Deceases Propaedeutic Department, Kuban State Medical University, Krasnodar, Russia

9 Biology Department with a course of Medical Genetics, Kuban State Medical University, Krasnodar, Russia

10 Experimental and Clinical Pathology Department, Al. Natishvili Institute of Morphology, Iv. Javakhishvili Tbilisi State University, Tbilisi, Georgia

11 Heart Failure Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

12 Isfahan Cardiovascular Research Center , Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.48305/arya.2023.41534.2888
Abstract
Sarcoidosis is a complex multisystem inflammatory granulomatous disease that can affect any organ, with a wide range of clinical presentations. A significant number of patients with systemic sarcoidosis may also have cardiac involvement. Clinical manifestations of cardiac sarcoidosis can include various rhythm and conduction disturbances, as well as heart failure.
The structure of sarcoid granulomas is similar to that of tuberculous granulomas, but in contrast, they lack caseous necrosis. Tissue changes in sarcoidosis tissues depend on the stage of development of the disease, progressing from pathological process: macrophage-lymphocytic infiltration to epithelioid cell granuloma formation, and fibrosis. Granulomas can be found in any part of the myocardium, with the most common locations being the free wall of the left ventricle, the basal part of the interventricular septum, and the interatrial septum. Vasculopathy of the pulmonary circulation and coronary arteries is often observed.
Advancements in diagnostic imaging techniques, such as computer tomography and magnetic resonance imaging, have facilitated the verification of cardiac sarcoidosis. This article presents an analysis of updated information on cardiac sarcoidosis by a multidisciplinary working group.
 

Keywords

Sarcoidosis
Heart
Myocardium
Biopsy
Heart failure
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ARYA Atherosclerosis Journal
Volume 19, Issue 5
September and October 2023
Pages 52-62

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