{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:36Z","timestamp":1753876236609,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although methotrexate has been widely used as a second-line therapy for cardiac sarcoidosis (CS), it is not clear if it has a direct anti-inflammatory effect.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 65-year-old man presented to our hospital with symptomatic ventricular tachycardia (VT). After cardioversion, electrocardiography showed a first-degree atrioventricular block with a right bundle branch block, and transthoracic echocardiography revealed left ventricular dilatation. After extensive investigations, including fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET), the patient was diagnosed with CS according to the Japanese Circulation Society guidelines. After the implantation of a transvenous implantable cardioverter defibrillator, corticosteroid therapy was introduced at a starting dose of 30\u2005mg\/day. After corticosteroid therapy was tapered to a maintenance dose of 10\u2005mg\/day, he had an uneventful clinical course without symptoms for the 1st year after hospital discharge. However, symptomatic VT recurred and 18F-FDG PET showed abnormal patterns of cardiac FDG uptake. Although he was treated with corticosteroid therapy once more, which was gradually up-titrated to a dose of 20\u2005mg\/day over a 1-month period, myocardial uptake of 18F-FDG PET remained unchanged. As the patient was considered steroid refractory, second-line treatment with 6\u2005mg\/week of methotrexate was introduced, whereas maintaining the dose of corticosteroid therapy at 20\u2005mg\/day. After 1 month, 18F-FDG PET showed remarkable reduction in FDG uptake, and the patient had a good clinical course without further episodes of arrhythmia or other symptoms during an 8-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Methotrexate may have a direct anti-inflammatory effect in patients with CS refractory to regular corticosteroid therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac226","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T23:14:50Z","timestamp":1654038890000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of methotrexate as a second-line treatment for cardiac sarcoidosis assessed via 18F-FDG PET: a case report"],"prefix":"10.1093","volume":"6","author":[{"given":"Taishi","family":"Dotare","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5438-3500","authenticated-orcid":false,"given":"Daichi","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033 , Japan"},{"name":"Department of Cardiology, Osaka Medical and Pharmaceutical University , 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2456-8525","authenticated-orcid":false,"given":"Yuya","family":"Matsue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1627-6151","authenticated-orcid":false,"given":"Tohru","family":"Minamino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"2022063018172462800_ytac226-B1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1183\/09031936.00075307","article-title":"Epidemiology of sarcoidosis in Japan","volume":"31","author":"Morimoto","year":"2008","journal-title":"Eur Respir J"},{"key":"2022063018172462800_ytac226-B2","first-page":"29","article-title":"Sarcoidosis: epidemiology and prognosis. 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