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Konsensuspapier der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP) und der Deutschen Gesellschaft für Kardiologie – Herz und Kreislaufforschung (DGK) zur Diagnostik und Therapie der kardialen Sarkoidose

Consensus paper of the German Respiratory Society (DGP) and the German Cardiac Society (DGK) on diagnostics and therapy of cardiac sarcoidosis

  • Konsensuspapiere
  • Published:
Der Kardiologe Aims and scope

Zusammenfassung

Während 90 % aller Sarkoidosepatienten eine parenchymatöse Beteiligung der Lunge aufweisen, ist die kardiale Sarkoidose (in weniger als 10 % der Fälle klinisch manifest) selten. Generell können alle Strukturen des Herzens von der Granulombildung betroffen sein. Meist jedoch sind das Myokard des linken Ventrikels sowie das Reizleitungssystem beeinträchtigt. Klinisch manifestiert sich die kardiale Sarkoidose als dilatative Kardiomyopathie oder in Form von Herzrhythmusstörungen wie Vorhofflimmern und/oder ventrikulären Tachykardien. Das Spektrum reicht von der benignen, subklinischen Manifestation als Zufallsbefund bis zur lebensbedrohlichen Komplikation. Diagnostische Schritte und therapeutische Empfehlungen zur kardialen Sarkoidose liegen im deutschsprachigen Raum bisher nicht vor. Die vorliegende Arbeit ist eine Expertenstellungnahme unter dem Schirm der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP) und der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung (DGK). Die nachstehenden Empfehlungen ersetzen jedoch nicht die ärztliche Begutachtung des individuellen Patienten und Anpassung der Diagnostik und Therapie an dessen spezifische Situation.

Abstract

Sarcoidosis is a multisystemic granulomatous disorder which affects the respiratory system in the majority of the cases. Cardiac manifestations are found in less than 10 % of the affected cohorts and show a large heterogeneity based on the ethnic background. Cardiac sarcoidosis is not only found in patients with rhythmogenic heart disease, such as atrial and ventricular fibrillation but also in all phenotypes of cardiomyopathy. The overall morbidity and mortality caused by cardiac sarcoidosis in Germany is unclear and no large prospective international studies have been published on this topic. This consensus paper on diagnostic and therapeutic algorithms for cardiac sarcoidosis is based on a current literature search and forms an expert opinion statement under the auspices of the German Respiratory Society and the German Cardiac Society. The rationale of this statement is to provide algorithms to facilitate clinical decision-making based on the individual case situation.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. U. Costabel, D. Skowasch, S. Pabst, S. Störk, C. Tschöpe, M. Allewelt, H. Worth, J. Müller-Quernheim J und C.  Grohé geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung Pneumologie-Allergologie, Ruhrland-Klinik Essen - Universitätsklinik Essen, Essen, Deutschland

    U. Costabel

  2. Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Deutschland

    D. Skowasch & S. Pabst

  3. Medizinische Klinik und Poliklinik I – Deutsches Zentrum für Herzinsuffizienz, Universität Würzburg, Würzburg, Deutschland

    S. Störk

  4. Abteilung für Kardiologie und Pneumologie, Charité Campus Benjamin Franklin (CBF) Universitätsmedizin Berlin, Deutsches Zentrum für Herz - Kreislaufforschung (DZHK), Berlin, Deutschland

    C. Tschöpe

  5. Klinik für Pneumologie, Ev. Lungenklinik Berlin-Buch, Lindenberger Weg 27, 13125, Berlin, Deutschland

    M. Allewelt &  C. Grohé

  6. Medizinische Klinik 1, Klinikum Fürth, Fürth, Deutschland

    H. Worth

  7. Abteilung Pneumologie, Universitätsklinikum Freiburg, Freiburg, Deutschland

    J. Müller-Quernheim

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  1. U. Costabel
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  8. J. Müller-Quernheim
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  9. C. Grohé
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Correspondence to C. Grohé.

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Dieser Beitrag wurde in den Zeitschriften Der Kardiologe und Pneumologie zeitgleich publiziert.

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Costabel, U., Skowasch, D., Pabst, S. et al. Konsensuspapier der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP) und der Deutschen Gesellschaft für Kardiologie – Herz und Kreislaufforschung (DGK) zur Diagnostik und Therapie der kardialen Sarkoidose. Kardiologe 8, 13–25 (2014). https://doi.org/10.1007/s12181-013-0550-z

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