Corticosteroid Therapy and Long-term Prognosis
A prospective randomized trial to investigate the efficacy of corticosteroids in cardiac sarcoidosis is lacking. Several studies have shown that early initiation of corticosteroids results in better clinical outcomes.15, 16 The results in the present study were concordant with that. Although the echocardiographic response in group 1 was poorer than that in the other groups, the cardiovascular death and heart failure hospitalizations in group 1 were low. Early initiation of the corticosteroid therapy could prevent recurrent inflammation and an expansion of sarcoidosis lesions. In fact, only 14% of the patients in group 1 had active inflammation (increased FDG uptake) of the heart, as compared to 70% in group 2. Progression of abnormal CS lesions could be delayed or suppressed by earlier corticosteroids therapy, which would improve their clinical outcomes.