{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:01:37Z","timestamp":1789070497260,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cardiac sarcoidosis (CS) is a granulomatous inflammatory cardiomyopathy with heterogeneous presentations, from palpitations to heart failure and sudden cardiac arrest. Despite advances in imaging and immunosuppressive (IS) therapy, relapse patterns and long-term outcomes remain poorly defined. This study aimed to characterize relapse and identify predictors of relapse and major adverse cardiac events (MACE) in a real-world CS cohort. Methods: This retrospective single-center study included 25 adults diagnosed with CS at Geneva University Hospitals between 2016 and 2024, classified per the 2024 American Heart Association diagnostic criteria. Relapse was defined as clinical, arrhythmic, or imaging deterioration requiring treatment escalation. MACE included cardiovascular hospitalization, device therapy, left ventricular assist device, heart transplant, or death. Statistical methods included Kaplan\u2013Meier analysis with log-rank tests and multivariable Cox regression adjusted for age and sex. Results: Relapse occurred in 13 patients (56%), frequently subclinical (61.5%) and detected incidentally on routine PET-CT during IS tapering. In the multivariate model, predictors of relapse included right ventricular FDG uptake (aHR 13.1; 95% CI 1.3\u2013133.7; p = 0.03) and second-line immunosuppression duration \u226424 months (aHR 20.1; 95% CI 1.1\u2013363.8; p = 0.04). Relapse-free patients were more often maintained on dual or triple IS therapy (71.4% vs. 15.4%; p = 0.02) and low-dose prednisone (&lt;10 mg\/day) (57.1% vs. 7.7%; p = 0.03). Conclusions: Relapse is common in CS, often subclinical, and associated with PET-CT findings and premature IS tapering. Maintenance therapy may reduce risk. Multimodal imaging remains critical for disease monitoring, though tracers with higher specificity are needed. Further research should refine relapse definitions and support personalized treatment strategies.<\/jats:p>","DOI":"10.3390\/jcm14176234","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T15:15:57Z","timestamp":1756912557000},"page":"6234","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Relapse Patterns and Clinical Outcomes in Cardiac Sarcoidosis: Insights from a Retrospective Single-Center Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6922-6230","authenticated-orcid":false,"given":"Arnaud","family":"Dominati","sequence":"first","affiliation":[{"name":"Division of Clinical Immunology and Allergology, Department of Medicine, Geneva University Hospital, 1205 Geneva, Switzerland"},{"name":"Division of Rheumatology, Department of Medicine, University of Illinois College of Medicine in Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5719-8423","authenticated-orcid":false,"given":"Geoffrey","family":"Urbanski","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Allergology, Department of Medicine, Geneva University Hospital, 1205 Geneva, Switzerland"},{"name":"Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Meyer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Geneva University Hospital, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5748-4577","authenticated-orcid":false,"given":"J\u00f6rg D.","family":"Seebach","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Allergology, Department of Medicine, Geneva University Hospital, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"ref_1","first-page":"26","article-title":"Racial Difference in Cardiac Sarcoidosis Incidence Observed at Autopsy","volume":"11","author":"Iwai","year":"1994","journal-title":"Sarcoidosis"},{"key":"ref_2","first-page":"1437","article-title":"Complementary Role of CMR to Conventional Screening in the Diagnosis and Prognosis of Cardiac Sarcoidosis","volume":"10","author":"Kouranos","year":"2017","journal-title":"JACC: Cardiovasc. 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