{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:18:20Z","timestamp":1792671500405,"version":"4.5.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiac sarcoidosis (CS) and giant cell myocarditis (GCM) share many histopathologic and clinical features. Whether they are parts of a one\u2010disease continuum has been discussed.<\/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              We compared medical record data of 351 CS and 28 GCM cases diagnosed in Finland since the late 1980s and followed until February 2018 for a composite end point of cardiac death, aborted sudden death, and heart transplantation. Heart failure was the presenting manifestation in 50% versus 15% (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and high\u2010grade atrioventricular block in 21% versus 43% (\n              <jats:italic>P<\/jats:italic>\n              =0.044), of GCM and CS, respectively. At presentation, left ventricular ejection fraction was \u226450% in 81% of cases of GCM versus in 48% of CS (\n              <jats:italic>P<\/jats:italic>\n              =0.004). The median (interquartile range) of plasma NT\u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide) was 5273 (2782\u201311309) ng\/L on admission in GCM versus 859 (290\u20131950) ng\/L in CS (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and cardiac troponin T exceeded 50\u00a0ng\/L in 17 of 19 cases of GCM versus in 48 of 239 cases of CS (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The 5\u2010year estimate of event\u2010free survival was 77% (95% CI, 72%\u201382%) in CS versus 27% (95% CI, 10%\u201345%) in GCM (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). By Cox regression analysis, GCM predicted cardiac events with a hazard ratio of 5.16 (95% CI, 2.82\u20139.45), which, however, decreased to 1.58 (95% CI, 0.71\u20133.52) after inclusion of markers of myocardial injury and dysfunction in the model.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">GCM differs from CS in presenting with more extensive myocardial injury and having worse long\u2010term outcome. Yet the key determinant of prognosis appears to be the extent of myocardial injury rather than the histopathologic diagnosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019415","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T10:11:51Z","timestamp":1614852711000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Manifestations and Outcome of Cardiac Sarcoidosis and Idiopathic Giant Cell Myocarditis by 25\u2010Year Nationwide Cohorts"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0114-114X","authenticated-orcid":false,"given":"Hanna\u2010Kaisa","family":"Nordenswan","sequence":"first","affiliation":[{"name":"Heart and Lung Center University of Helsinki and Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Lehtonen","sequence":"additional","affiliation":[{"name":"Heart and Lung Center University of Helsinki and Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaj","family":"Ekstr\u00f6m","sequence":"additional","affiliation":[{"name":"Heart and Lung Center University of Helsinki and Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2154-7377","authenticated-orcid":false,"given":"Anne","family":"R\u00e4is\u00e4nen\u2010Sokolowski","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Helsinki and Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikko I.","family":"M\u00e4yr\u00e4np\u00e4\u00e4","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Helsinki and Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapani","family":"Vihinen","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki","family":"Miettinen","sequence":"additional","affiliation":[{"name":"Heart Center Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Kaikkonen","sequence":"additional","affiliation":[{"name":"Medical Research Center Oulu University and University Hospital of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petri","family":"Haataja","sequence":"additional","affiliation":[{"name":"Heart HospitalTampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas","family":"Kerola","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine P\u00e4ij\u00e4t\u2010H\u00e4me Central Hospital Lahti Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1914-2282","authenticated-orcid":false,"given":"Tuomas T.","family":"Rissanen","sequence":"additional","affiliation":[{"name":"Heart Center North Karelia Central Hospital Joensuu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorma","family":"Kokkonen","sequence":"additional","affiliation":[{"name":"Central Finland Central Hospital Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksi","family":"Alatalo","sequence":"additional","affiliation":[{"name":"South Ostrobothnia Central Hospital Sein\u00e4joki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Pietil\u00e4\u2010Effati","sequence":"additional","affiliation":[{"name":"Vaasa Central Hospital Vaasa Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seppo","family":"Utriainen","sequence":"additional","affiliation":[{"name":"South Karelia Central Hospital Lappeenranta Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Kupari","sequence":"additional","affiliation":[{"name":"Heart and Lung Center University of Helsinki and Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-012-9358-3"},{"key":"e_1_3_2_3_2","first-page":"1126","article-title":"Giant cell myocarditis: an entity distinct from sarcoidosis characterized by multiphasic myocyte destruction by cytotoxic T cells and histiocytic giant cells","volume":"9","author":"Litovsky SH","year":"1996","unstructured":"Litovsky SH, Burke AP, Virmani R. 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