Nikhil Prasad Fact checked by:Thailand Medical News Team Jan 15, 2026 1 hour, 32 minutes ago
Medical News: Early Clues to a Silent Threat
A new investigation from researchers across leading Greek institutions has uncovered a subtle but powerful biological warning sign that may reveal early heart damage in people with sarcoidosis long before symptoms appear. The study involved experts from the National and Kapodistrian University of Athens, Sotiria General Hospital for Chest Diseases, Aeginition Hospital, Hippocration General Hospital, Attikon Hospital and the 2nd Department of Radiology.
Aldosterone levels may reveal early hidden heart fibrosis in sarcoidosis before standard scans detect visible damage
This
Medical News report highlights how elevated levels of the hormone aldosterone strongly signal the early development of cardiac fibrosis even when standard scans show no visible scarring.
Understanding the Challenge
Sarcoidosis is a multi-system disease that most often affects the lungs and lymph nodes. It is an inflammatory disease where immune cells form tiny, swollen lumps called granulomas in organs like the lungs, lymph nodes, skin, and eyes, potentially disrupting organ function. It's not contagious, and its exact cause is unknown, but it's thought to involve genetic and environmental factors or even viral infections triggering an immune overreaction. However, when it reaches the heart, the consequences can be deadly, leading to rhythm disturbances, weakening of the heart muscle and sudden cardiac death. Detecting cardiac sarcoidosis early has long been a medical challenge because many patients show no symptoms until significant damage has occurred.
Modern imaging tools like cardiac MRI and PET/CT have improved detection, but they still miss the earliest forms of diffuse microscopic scarring. The new study suggests a simple blood test may help bridge this diagnostic gap.
Large Patient Study Reveals Hormonal Signal
The research examined 541 adults with biopsy-proven sarcoidosis and normal heart pumping function. Every participant underwent detailed cardiac MRI mapping, PET/CT scans and laboratory analysis including aldosterone measurement.
Patients diagnosed with cardiac sarcoidosis showed significantly higher aldosterone levels—median 172 pg/mL compared to 143 pg/mL in those without heart involvement. Importantly, aldosterone levels closely correlated with higher extracellular volume (ECV) on MRI, a sensitive measurement reflecting diffuse early myocardial fibrosis. A 100 pg/mL rise in aldosterone produced almost a 1 percent increase in ECV, strengthening the link between this hormone and the fibrotic process.
Notably, aldosterone showed no connection to inflammation markers on PET/CT or to T1 and T2 mapping values, indicating that the hormone tracks fibrosis rather than inflammation. This distinction suggests the hormone may be identifying a different disease pathway that begins before visible scar tissue appears.
A Possible Early Diagnostic Tool
The finding that aldosterone levels predict
fibrosis even in patients without late gadolinium enhancement—MRI’s classic sign of established scarring—is particularly meaningful. It signals that aldosterone could help detect damage at its very earliest stage, when treatment may be most effective.
Conclusions
The study demonstrates that plasma aldosterone is a strong and independent marker of early diffuse cardiac fibrosis in sarcoidosis, functioning even when imaging results appear normal. These findings may reshape screening strategies by adding a low-cost blood test capable of identifying high-risk patients at a pre-symptomatic stage. The results also support further exploration of aldosterone-blocking therapies, which could potentially slow or prevent heart damage in this vulnerable population. As early scarring is often silent yet progressive, a biomarker that exposes hidden changes could significantly improve long-term outcomes.
The study findings were published in the peer reviewed Journal of Clinical Medicine.
https://www.mdpi.com/2077-0383/15/2/650
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