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Management Of Cardiac Sarcoidosis in the United States: A Delphi study.
MedLine Citation:
PMID:  21737493     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract: BACKGROUND: No formal guidelines exist to guide physicians caring for sarcoid patients in their screening for management of cardiac sarcoidosis patients. We conducted a modified Delphi study to investigate if a consensus could be reached on the best approaches for screening for and management of cardiac sarcoidosis. METHODS: A modified Delphi study design with 2 rounds of questionnaires was utilized to investigate if a consensus existed among sarcoid experts in the US on the best management approaches for cardiac sarcoidosis. Experts were identified based on their national reputation as sarcoid experts and by being actively involved in sarcoidosis clinics at their institutions. RESULTS: Overall agreement was low to moderate. Agreement was reached on the role of history, physical exam and 12-lead ECG in screening, echocardiogram, Holter monitor, myocardial Fluoro-Deoxy-Glucose Positron Emission Tomography and cardiac Magnetic Resonance Imaging in workup and steroids in treatment. Agreement was not reached on role of Signal Averaged ECG in screening, optimum dose of prednisone, use of steroid sparing agents, and duration of treatment. Several comments underscore the diverse approaches and uncertainty that exists in managing cardiac sarcoidosis. CONCLUSIONS: Our study highlights the dilemma that sarcoid experts face in their approach to cardiac sarcoidosis, it also highlights the lack of agreement among sarcoid experts on key aspects of diagnosis and management stresses the importance of collaborative efforts to investigate the best strategies for screening for and management of cardiac sarcoidosis.
Authors:
Nabeel Y Hamzeh; Frederick S Wamboldt; Howard D Weinberger
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-7
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Environmental and Occupational Health Sciences, National Jewish Health hamzehn@njhealth.org.
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