Myocardial contractile patterns predict future cardiac events in sarcoidosis

• DOI: 10.1007/s10554-017-1233-9
• Publication Date: 2017-09-11T12:27:03Z
• Authors: Jian Chen; Juan Lei; Ernest Scalzetti; Mary McGrath; David Feiglin; Robert Voelker; Jingfeng Wang; Michael C. Iannuzzi; Kan Liu
• Keywords: Adult; Male; Chi-Square Distribution; Reproducibility of Results; Kaplan-Meier Estimate; Middle Aged; Myocardial Contraction; Disease-Free Survival; Biomechanical Phenomena; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Echocardiography; Predictive Value of Tests; Area Under Curve; Multivariate Analysis; Disease Progression; Humans; Female; Cardiomyopathies; Proportional Hazards Models; Retrospective Studies

The poor prognosis of cardiac sarcoidosis (CS) underscores the need for risk stratification. We evaluated 84 consecutive sarcoidosis patients who were referred for echocardiographic studies for cardiac symptoms or abnormal electrocardiograms. In 54 patients without previous diagnosis of CS or other known structural heart disease, 13 reached endpoints during (median) 24 months follow up. Significantly impaired peak systolic longitudinal strain in their original echocardiograms were identified in 13 of 17 left ventricular segments, clustering in the free wall, interventricular septum and apex. The regional (including 13 clustered segments) peak systolic longitudinal strain (RPSLS) were significantly impaired in patients with endpoints, compared with those without [(-11.4 ± 4.45) vs. (-18.7 ± 3.76) %, P < 0.00001]. Cox multivariate regression analysis revealed that RPSLS was independently associated with endpoints (HR 1.24; 95% CI 1.08-1.42, P = 0.002). Receiver operating characteristic curve suggested a cut-off RPSLS value of -15.0% (84.6% sensitivity and 86.8% specificity) to predict the occurrence of endpoints. Impaired RPSLS correlates with risk of adverse cardiac events in patients with extra-cardiac sarcoidosis.