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1.
Indian Pacing Electrophysiol J ; 22(4): 169-178, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35398517

RESUMO

BACKGROUND: Granulomatous cardiomyopathy (GCM) is relatively uncommon in patients presenting with ventricular tachycardia (VT). Sarcoidosis and tuberculosis are the most common causes of GCM with VT. The aim of study was to evaluate their clinical characteristics and the long-term outcomes. METHODS: We retrospectively analyzed patients from March 2004 to January 2020, presenting with VT and subsequently diagnosed to have GCM. Patients were divided into three groups (sarcoid, tuberculosis and indeterminate) based on serologic tests, imaging and histopathology. The response to anti-arrhythmic and disease specific therapy on long-term follow-up were analyzed. RESULTS: There were 52 patients, comprising 27 males and 25 females, age 40 ± 10 years. The follow-up period was 5.9 ± 3.9 years. Sarcoidosis was diagnosed in 20 (38%); tuberculosis (TB) in 15(29%) and 17(33%) patients were indeterminate. Left ventricular ejection fraction (LVEF) of the entire cohort was 0.45 ± 0.14. Erythrocyte Sedimentation Rate(ESR) was found to be significantly higher in TB(43.6 ± 18.4) patients vs sarcoid(18.9 ± 6.7)p < 0.0001, but not the indeterminate group (36.2 ± 21.1), p = 0.3. Implantable Cardioverter Defibrillator (ICD) implantation was performed in 12/20(60%) patients in the sarcoid group, in 4/15(27%) patients in the TB group and in 10/17(59%) patients in the indeterminate group. At a mean follow-up of six years, VT recurrences were noted in 6, 2, and 7 patients in the sarcoid, TB and indeterminate groups respectively. CONCLUSION: Despite the advances in diagnostic modalities for tuberculosis and sarcoidosis, in real-world practice, almost one-third of the patients with VT and GCM have uncertain etiology. Long term outcomes of patients presenting with GCM and VT with mild left ventricle dysfunction treated appropriately seems favorable.

2.
J Assoc Physicians India ; 67(12): 30-34, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31801327

RESUMO

OBJECTIVE: Study etiology of Non ischemic cardiomyopathy (NICMP) and role of cardiac MRI in diagnosis and outcomes. METHODS: prospective observational study. INCLUSION CRITERIA: 1. Clinical feature of cardiac failure, 2. 2D ECHO Systolic dysfunction, EF <45% OR Diastolic dysfunction without regional wall motion abnormality, 3. Absent ischemic changes on ECG and/ or coronary angiography. Exclusion: Valvular & congenital heart disease, Cor pulmonale, Renal failure. Patient were subjected to CBC with absolute eosinophil count(AEC), ESR, Urine-r/m, NT-Pro-BNP, ANA, ANCA, ACE, Bone marrow, Amyloid fat pad biopsy etc., chest x ray, 2DE. HRCT Chest and coronary angiography, Cardiac MRI by 3 tesla MRI machine. Patients were treated with antic-failure drugs & as per etiology and followed at 6wk clinically (NYHA) and 2DE. RESULT: forty four Patients, mean age 36 yrs F: M(22:22), many patients had feature other than cardiac failure like Raynaud's.


Assuntos
Cardiomiopatias/diagnóstico , Insuficiência Cardíaca , Adulto , Angiografia Coronária , Humanos , Imageamento por Ressonância Magnética , Estudos Prospectivos
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