Abstract
Background: Detection of cardiac involvement in patients with sarcoidosis has major clinical significance due to its poor prognosis. This study examined whether various electrical, functional and structural modalities may have be able to predict cardiovascular events in this group of patients.
Methods: All consecutive patients underwent chest X-ray, pulmonary function testing, electrocardiogram/24-hour ambulatory Holter monitoring, echocardiogram and cardiac MRI. Cardiac sarcoidosis was clinically assessed according to the 2006 revised Japanese Ministry of Health criteria. All patients were followed up for 48.57±30.5 months.
Results: A total of 156 newly diagnosed patients, with biopsy proven sarcoidosis were enrolled in the study (mean age 48.8 ± 11.9 years). Fifteen (9.6%) were clinically diagnosed with cardiac sarcoidosis. A total of 13 (8.3%) cardiovascular events emerged in the follow up period with 2 deaths and 8 ventricular arrhythmias. All deaths were attributed to cardiac sarcoidosis but the rest of the events were found to non-cardiac sarcoidosis patients. Patients with events in follow up were older, had higher BNP, lower DLCO and more frequent LGE. The Cox regression analysis showed that LGE was an independent predictor of cardiovascular events and mortality.
Conclusion: Currently employed diagnostic criteria of cardiac sarcoidosis may not be used for risk stratification of patients with sarcoidosis. Cardiac MRI in our cohort is the strongest predictor of cardiovascular life-threatening events and mortality.
- © 2014 ERS