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Cardiac Sarcoidosis Multi-Center Prospective Cohort

Cardiac Sarcoidosis

Recent data has shown that sarcoidosis, presenting initially with cardiac manifestations (CS) of either conduction system disease or cardiomyopathy and sustained VT, is not uncommon. A Canadian physician survey found that most physicians do not investigate for CS as a possibility in these situations. Thus many patients with clinically important CS are going un-diagnosed. A study from Finland showed that missing the diagnosis of CS in these patients' leads to significant mortality and morbidity.

There are no published clinical consensus guidelines on treatment of CS. Corticosteroid therapy is advocated by most experts. This is based on very modest data from small retrospective observational studies using variable definitions of clinical response. The effect of corticosteroid treatment on the clinical course of CS has not been studied in prospective studies and will be one of the aims of this project. Recent physician surveys regarding CS, in Canada and the US, found that current clinical practice varies widely. The 2008 American College of Cardiology/American Heart Association/Heart Rhythm society guidelines recommend implantation of a defibrillator (Class IIa recommendation) to prevent sudden cardiac death. The most recent Canadian device therapy guidelines do not mention CS.

A multi-center collaborative approach to study CS is greatly needed." The investigators propose exactly that i.e. a multi-center prospective cohort to start to answer clinical questions. The investigators have formed the CANADIAN CARDIAC SARCOIDOSIS RESEARCH GROUP. The group includes respirologists with an interest in sarcoidosis, cardiac electrophysiologists, cardiac imaging specialists with extensive experience in imaging of sarcoidosis and biostatisticians. The research will be in two phases; a registry of current diagnostic approaches, treatment and prognosis, and a randomized clinical trial of the effect of corticosteroid treatment on the clinical course of cardiac sarcoidosis.

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Conditions de participation

  • Sexe:

    ALL

  • Âges admissibles:

    18 and up

Critères de participation

Inclusion Criteria:

To diagnose Clinically Manifest CS all following criteria must be met:

(i) Positive biopsy\* for Sarcoid (either EMB or extra-cardiac) AND/OR (ii) CT Chest highly suggestive of pulmonary sarcoidosis AND (iii) one or more of the following clinical features:

* advanced conduction system disease (sustained Mobitz II AV block or third degree AV block)
* non- sustained or sustained ventricular arrhythmia
* ventricular dysfunction (LVEF \< 50% and/or RVEF \< 40%) AND (iv) No alternative explanation for clinical features AND (v) FDG-PET suggestive of active CS

To diagnose clinically silent CS all of the following criteria must be met

(i) Biopsy proven extra-cardiac sarcoidosis

AND/OR (ii) CT Chest highly suggestive of pulmonary sarcoidosis

AND (iii) CMR suggestive of cardiac sarcoidosis

AND (iv) Does not have criteria for clinically manifest CS ie. should not have any of following

* advanced conduction system disease (sustained Mobitz II AV block or third degree AV block)
* non- sustained or sustained ventricular arrhythmia
* ventricular dysfunction (LVEF \< 50% and/or RVEF \< 40%)

Patients with negative CMR will be designated as 'extra-cardiac sarcoidosis with no evidence of CS' and followed as control

Exclusion Criteria:

* unable or unwilling to provide informed consent
* patients who are pregnant or lactating
* patients with known claustrophobia
* age \< 18 years

Lieu de l'étude

St. Paul's Hospital
St. Paul's Hospital
Vancouver, British Columbia
Canada

Contactez l'équipe d'étude

Primary Contact

Shanta Chakrabarti, MD

Southlake Regional Health Centre
Southlake Regional Health Centre
Newmarket, Ontario
Canada

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Primary Contact

Bernice Tsang, MD

Centre Hospitalier de l"Universite de Montreal-Hotel Dieu
Centre Hospitalier de l"Universite de Montreal-Hotel Dieu
Montreal, Quebec
Canada

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Primary Contact

Julie Fleury, RN

University of Alberta Hospital
University of Alberta Hospital
Edmonton, Alberta
Canada

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Primary Contact

Tomascz Hruczkowski, MD

London Health Sciences Centre
London Health Sciences Centre
London, Ontario
Canada

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Primary Contact

Lorne Gula, MD

Montreal Heart Institute
Montreal Heart Institute
Montreal, Quebec
Canada

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Primary Contact

Lena Rivard, MD

QEII Health Sciences Center
QEII Health Sciences Center
Halifax, Nova Scotia
Canada

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Primary Contact

Kim Anderson, MD

McGill University Health Centre
McGill University Health Centre
Montreal, Quebec
Canada

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Primary Contact

Fiorella Rafti

University of Ottawa Heart Institute
University of Ottawa Heart Institute
Ottawa, Ontario
Canada

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Primary Contact

Janine E Ryan, BA H

[email protected]
613-696-7000
Backup Contact

Tammy Knight

[email protected]
613-696-7000
Libin Cardiovascular Institute of Alberta
Libin Cardiovascular Institute of Alberta
Calgary, Alberta
Canada

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Primary Contact

Russell Quinn, MD

Hamilton Health Sciences Centre
Hamilton Health Sciences Centre
Hamilton, Ontario
Canada

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Primary Contact

Jeff Healey, MD

Backup Contact

Gerard Cox, MD

Toronto General Hospital
Toronto General Hospital
Toronto, Ontario
Canada

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Primary Contact

Andrew Ha, MD

Prairie Vascular Research Inc-Regina General Hospital
Prairie Vascular Research Inc-Regina General Hospital
Regina, Saskatchewan
Canada

Contactez l'équipe d'étude

Primary Contact

Kendra Townsend

[email protected]
Étude parrainée par
Ottawa Heart Institute Research Corporation
Participants recherchés
Plus d'informations
ID de l'étude: NCT01477359