Impact of cardiac sarcoidosis on health-related quality of life

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Abstract
Background and Aims: Cardiac sarcoidosis (CS) carries a poorer prognosis than other sarcoidosis subtypes, but its impact on health-related quality of life (HRQoL) remains insufficiently characterized. To assess HRQoL in CS compared with pulmonary sarcoidosis (PS) and Finnish population norms, and to examine the prognostic value of patient-reported outcomes. Methods and Results: In this multicentre cohort, 240 CS patients from the MIDFIN registry and 65 PS patients completed the RAND-36 and fatigue severity scale (FSS). CS patients (median age 56 years; 75% women) had significantly lower physical functioning (PF) and role-physical (RP) scores than PS patients and age- and sex-standardized Finnish population norms (P < .001). Mental health domains did not differ significantly between CS and PS. Fatigue was comparable (FSS 4.2 vs 3.8; P = .149). Impairment was most pronounced in CS patients with reduced left ventricular ejection fraction and prior ventricular tachycardia/ventricular fibrillation or heart failure; those with preserved left ventricular ejection fraction and no adverse events had scores similar to PS. Over 36 months, 38 CS patients experienced composite adverse events (27 ventricular tachycardia/ventricular fibrillation, 7 deaths, 2 heart transplants, 1 left ventricular assist device, 1 pericardiocentesis for sarcoid pericarditis). In multivariable Cox regression, each 10-point decrement in PF (HR 1.16, 95% CI 1.02–1.32, P = .028) and RP (HR 1.14, 95% CI 1.04–1.25, P = .006) independently predicted adverse events, outperforming NYHA class, which lost independent prognostic significance when PF or RP was included in the model. Conclusions: CS substantially impairs physical HRQoL, and lower PF and RP scores predict adverse outcomes beyond conventional risk markers, supporting integration of HRQoL assessment into routine CS risk stratification.
Funding Information
  • Urho Känkänen foundation

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