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Underdiagnosis of cardiac sarcoidosis by ECG and echocardiography in cases of extracardiac sarcoidosis

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Title: Underdiagnosis of cardiac sarcoidosis by ECG and echocardiography in cases of extracardiac sarcoidosis
Authors: Ohira, Hiroshi Browse this author
Sato, Takahiro Browse this author
Manabe, Osamu Browse this author
Oyama-Manabe, Noriko Browse this author
Hayashishita, Akiko Browse this author
Nakaya, Toshitaka Browse this author
Nakamura, Junichi Browse this author
Suzuki, Naoko Browse this author
Sugimoto, Ayako Browse this author
Furuya, Sho Browse this author
Tsuneta, Satonori Browse this author
Watanabe, Taku Browse this author
Tsujino, Ichizo Browse this author
Konno, Satoshi Browse this author →KAKEN DB
Issue Date: 1-Apr-2022
Publisher: European respiratory society
Journal Title: ERJ Open Research
Volume: 8
Issue: 2
Start Page: 516
Publisher DOI: 10.1183/23120541.00516-2021
Abstract: Background Although screening with 12-lead electrocardiography and transthoracic echocardiography for cardiac involvement has been recommended for patients with biopsy-proven extracardiac sarcoidosis, cardiac sarcoidosis has been reported even in patients with normal electrocardiography and echocardiography findings. We investigated the prevalence and characteristics of these patient cohorts. Methods We studied 112 consecutive patients (age, 55 +/- 17 years, 64% females) with biopsy-proven extracardiac sarcoidosis who had undergone F-28-fluorodeoxyglucose positron emission tomography and cardiac magnetic resonance imaging for cardiac sarcoidosis evaluation. The patients were categorised as those showing normal findings both in electrocardiography and transthoracic echocardiography (normal group) and those showing abnormal findings in one or both examinations (abnormal group). Results 33 (29%) and 79 (71%) patients were categorised into the normal and abnormal groups, respectively, of which 6 (18%) and 43 (54%) patients, respectively, were diagnosed with cardiac sarcoidosis (p<0.01). Of these six patients in the normal group, two with multiple-organ sarcoidosis showed clinical deterioration of cardiac involvement and required steroid therapy; three with small cardiac involvement showed natural remission over follow-up assessments; and one underwent steroid therapy and showed an improvement in the left ventricular ejection fraction to within normal limits. Conclusions The prevalence of cardiac sarcoidosis in patients with biopsy-proven extracardiac sarcoidosis and normal electrocardiography and transthoracic echocardiography findings was similar to 20%. Electrocardiography and transthoracic echocardiography may not detect cardiac sarcoidosis in patients without conduction and morphological abnormalities. However, some of these patients may subsequently show clinically manifested cardiac sarcoidosis. Physicians should be mindful of this population.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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