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Article Dans Une Revue European Heart Journal Année : 2022

Prevalence, patterns and outcomes of cardiac involvement in Erdheim–Chester disease

Lévi-Dan Azoulay
Fleur Cohen-Aubart
Danielle Seilhean
Frédéric Charlotte
Zahir Amoura
Philippe Cluzel

Résumé

Abstract Aims Cardiac involvement of Erdheim–Chester disease (ECD), a rare L group histiocytosis, has been reported to be associated with poor outcomes, but systematic studies are lacking. The present study aimed to investigate the prevalence, clinical features, imaging features, and prognosis of cardiac involvement in ECD in a large series. Methods and results All patients with ECD who underwent cardiac magnetic resonance (CMR) imaging between 2003 and 2019 at a French tertiary center were retrospectively included. Primary outcome was all-cause mortality. Secondary outcomes were pericarditis, cardiac tamponade, conduction disorders, device implantation and coronary artery disease (CAD). A total of 200 patients were included [63 (54–71) years, 30% female, 58% BRAFV600E mutated]. Median follow-up was 5.5 years (3.3–9 years). On CMR, right atrioventricular sulcus infiltration was observed in 37% of patients, and pericardial effusion was seen in 24% of patients. In total, 8 patients (4%) had pericarditis (7 acute, 1 constrictive), 10 patients (5%) had cardiac tamponade, 5 patients (2.5%) had ECD-related high-degree conduction disorders, and 45 patients (23%) had CAD. Overall, cardiac involvement was present in 96 patients (48%) and was associated with BRAFV600E mutation [Odds ratio (OR) = 7.4, 95% confidence interval (CI) (3.5–16.8), P < 0.001] and ECD-related clinical events [OR = 5, 95%CI (1.5–21.2), P = 0.004] but not with lower survival in multivariate analysis [adjusted hazard ratio (HR) = 1.4, 95% CI (0.8–2.5), P = 0.2]. Conclusion Cardiac involvement is present in nearly half of ECD patients and is associated with BRAFV600E mutation and complications (pericarditis, cardiac tamponade, and conduction disorders) but not with lower survival.
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Dates et versions

hal-03916066 , version 1 (30-12-2022)

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Lévi-Dan Azoulay, Marine Bravetti, Fleur Cohen-Aubart, Jean-François Emile, Danielle Seilhean, et al.. Prevalence, patterns and outcomes of cardiac involvement in Erdheim–Chester disease. European Heart Journal, 2022, ⟨10.1093/eurheartj/ehac741⟩. ⟨hal-03916066⟩
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