Observational studyOpen heart2026
High prevalence of coxsackievirus B antibodies in patients with cardiac sarcoidosis: a retrospective cohort study.
Observational study in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCardiac sarcoidosis (CS) is a potentially life-threatening manifestation of sarcoidosis that is frequently underdiagnosed. Identifying accessible biomarkers that could identify cardiac involvement would improve early detection. Coxsackievirus B (CVB) is proposed as a potential infectious trigger in sarcoidosis, but its relationship to CS remains poorly understood.
methodsWe conducted a retrospective observational cohort study of patients with CS and available CVB antibody testing at the University of Kansas Health System between 2011 and 2025. Seropositivity was compared with published external comparator cohort populations, including participants from the MAVERIC registry and previously reported population-based studies. Patients ≥18 years who met Heart Rhythm Society or Japanese Circulation Society criteria for probable or definite CS were included. Demographic data, imaging findings, clinical characteristics and CVB antibody titres were extracted from the electronic medical record.
resultsA total of 56 patients with confirmed CS were included. Overall, 51 of 56 patients (91%) demonstrated CVB antibody positivity, with 80% exhibiting moderate or high titres. In an external comparator cohort population CVB positivity was 14.5%. Advanced imaging findings were consistent with cardiac involvement, including delayed gadolinium enhancement on cardiac MRI in 78% of patients and myocardial 18-fluorodeoxyglucose uptake on positron emission tomography in 87%. Conventional screening tests demonstrated limited sensitivity with abnormalities on ECG, echocardiography and ambulatory monitoring observed in a minority of patients.
conclusionsThis study demonstrates a high prevalence of CVB antibody positivity among patients with CS. These findings suggest that CVB serology may represent a low-cost screening biomarker to help identify patients who may benefit from further evaluation with advanced cardiac imaging.
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