{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:32:12Z","timestamp":1792481532528,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,1,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The diagnosis of cardiac sarcoidosis (\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              ) is challenging because endomyocardial biopsy has only a 20% to 30% sensitivity rate for diagnosis and it presents with similar clinical features of idiopathic dilated cardiomyopathy (\n              <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n              ). Lymphatic vessel proliferation in pulmonary sarcoidosis has been previously demonstrated. In this study, we compared endomyocardial biopsy samples obtained from patients with\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n              to determine whether lymph vessel counts using D2\u201040 immunostaining can be utilized as a complementary tool to distinguish\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              from\n              <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Endomyocardial biopsy tissues were obtained from 62 patients with\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              (30 patients with a diagnosis made histologically, 32 patients with a diagnosis made clinically), and hematoxylin\/eosin, Masson trichrome, and D2\u201040 immunostaining were performed. Their results were compared with those from 53 patients with DCM. The histological\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              group showed significantly increased lymphatic vessels (12.0 [4.0\u201340.0] versus 2.6 [1.9\u20133.4],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) and more severe mosaic fibrosis (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) compared with the\n              <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n              group. The optimal threshold was 7.5 lymphatic vessels, and this resulted in a sensitivity of 0.67 and specificity of 0.96. The clinical\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              group diagnosed according to Japanese Circulation Society 2016 criteria showed increased lymphatic vessels (4.0 [3.3\u20139.0] versus 2.6 [1.9\u20133.4],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), more severe mosaic fibrosis (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), more inflammatory cell infiltration (53% versus 0%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), and fatty infiltration within fibroblasts (50% versus 17%,\n              <jats:italic>P<\/jats:italic>\n              =0.0012) compared with the\n              <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n              group. The optimal threshold of lymphatic vessels was 3.5, which resulted in a sensitivity of 0.75 and specificity of 0.68.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Lymphatic vessel counts using D2\u201040 immunostaining may help to distinguish clinical\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              without granuloma from\n              <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010967","type":"journal-article","created":{"date-parts":[[2019,1,12]],"date-time":"2019-01-12T10:00:25Z","timestamp":1547287225000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Lymph Vessel Proliferation on Cardiac Biopsy May Help in the Diagnosis of Cardiac Sarcoidosis"],"prefix":"10.1161","volume":"8","author":[{"given":"Yukiko","family":"Oe","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine and Allergy and Rheumatology Department of Medicine Rutgers New Jersey Medical School Newark NJ"},{"name":"Department of Pathology National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatsue","family":"Ishibashi\u2010Ueda","sequence":"additional","affiliation":[{"name":"Department of Pathology National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taka\u2010aki","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine Showa University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Hong","family":"Kuo","sequence":"additional","affiliation":[{"name":"Biostatistics Core Office of Research Administration Hackensack Meridian Health Neptune NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokkaido University Graduate School of Medicine Hokkaido Japan"},{"name":"Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Pathology National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Ohta\u2010Ogo","sequence":"additional","affiliation":[{"name":"Department of Pathology National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruo","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihisa","family":"Anzai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokkaido University Graduate School of Medicine Hokkaido Japan"},{"name":"Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-14-1275"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-007-0614-1"},{"key":"e_1_3_2_4_2","first-page":"1686","article-title":"Successful treatment of cardiac sarcoidosis with infliximab","volume":"35","author":"Barnabe C","year":"2008","unstructured":"Barnabe C, McMeekin J, Howarth A, Martin L. 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