cardiology-nutrition-health-2018-posters-abstracts

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Journal of Nutrition and Human Health | Volume 2

October 29-30, 2018 | London, UK

Joint Event

Nutrition and Fitness

International Conference on

World Congress on

Card i o l ogy

Heart transplantation in female recipient with cardiac sarcoidosis

Maria Simonenko

Almazov National Medical Research Centre, Russia

here is a challenge to diagnose cardiac sarcoidosis (CS) which

is extremely rare multisystem disease. Often it is diagnosed

only in patients with end-stage chronic heart failure (CHF). A

30-yr-old female patient from her early childhood coped with

arrhythmias, such as paroxysmal frequent supraventricular

tachycardia. At theageof 9WPWwas found, and sheunderwent

epicardial catheter ablation (CA) of accessory atrioventricular

(AV) pathways. Since 13-yrs-old frequent syncope-associated

ventricular extrasystoles were diagnosed. When she was 17-yr-

old, CA of left posterior accessory connections of AV pathway

was performed. Then cardiac pacemaker was implanted due to

complete AV block. Moreover, LVEF dropped to 30%. To prevent

sudden cardiovascular death we implanted CRT+D. Less in 1 yr

patient was admitted to our hospital with CHF NYHA class III.

According to TTE, LVEF was 20%, mitral regurgitation grade 4.

Due to shewas hemodinamically unstablewe couldnot perform

endomyocardial biopsy (EMB) prior heart transplantation

(HTx). Patient’s examination did not show any mediastinal

lymphadenopathy or lung lesions. Despite the treatment,

patient’s condition deteriorated. She was heart transplanted

less than in 6 months. Time in ICU was complicated by severe

right heart failure. Two weeks after HTx we performed Batista

procedure with mitral valve repair. Explanted heart biopsy

revealed typical sarcoidosis signs: specific myocarditis, non-

necrotic granulomas, fibrosis fields. Patient was treated with

triple-drugtherapy(steroids,tacrolimus,mycophenolicacid)plus

the induction (thymoglobulin). After HTx EMB did not reveal any

signs of myocardial cellular rejection or specific granulomatosis.

In long-term follow-up there was no signs of CHF. In fact, 5 yrs

after HTx according to EMB results there was no signs of CS.

In conclusion, HTx can be considered as an effective treatment

for patients with CS complicated by end-stage CHF. Post-HTx

immunosuppressive therapy may prevent sarcoidosis relapse.