Cardiac involvement in Caucasian patients with pulmonary sarcoidosis

Respiratory Research

Johan Grunewald¹  Anders Eklund¹  Kerstin Cederlund⁴  Peder Sörensson²  Anders Gabrielsen²  Pernilla Darlington³ 

[1] Respiratory Medicine Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden;Cardiology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden;Respiratory Medicine Unit, Department of Medicine, Karolinska Institutet and Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden;Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden

关键词: Sarcoidosis;    Human leukocyte antigen;    Cardiovascular magnetic resonance;    Extra-pulmonary involvement;    Cardiac sarcoidosis;   

Others  :  790605
DOI  :  10.1186/1465-9921-15-15

 received in 2013-10-21, accepted in 2014-02-03,  发布年份 2014

【 摘 要 】

Background

Cardiac sarcoidosis (CS) is a potentially life-threatening condition. At present, there is no consensus with regard to the optimal non-invasive clinical evaluation and diagnostic procedures of cardiac involvement in patients with sarcoidosis. The aim of this study in a large homogenous Scandinavian sarcoidosis cohort was therefore to identify risk factors of cardiac involvement in patients with sarcoidosis, and the value of initial routine investigation with ECG and cardiac related symptoms in screening for CS.

Methods

In this retrospective study a cohort of 1017 Caucasian patients with sarcoidosis were included. They were all screened with ECG at disease onset and investigated for CS according to clinical routine.

Results

An abnormal ECG was recorded in 166 (16.3%) of the 1017 patients and CS was later diagnosed in 22 (13.2%) of them, compared to in one (0.1%) of the 851 sarcoidosis patients with a normal ECG (p < 0.0001). The risk for CS was higher in patients with a pathologic ECG combined with cardiac related symptoms (11/40) (27.5%) compared to those with pathologic ECG changes without symptoms (11/126) (8.7%) (p < 0.01). Furthermore, patients with Löfgren’s syndrome had a reduced risk for CS compared to those without (p < 0.05) the syndrome.

Conclusions

This study on an unusually large and homogenous sarcoidosis population demonstrate the importance of an abnormal ECG and cardiac related symptoms at disease onset as powerful predictors of a later diagnosis of cardiac sarcoidosis. In contrast, CS is very rare in subjects without symptoms and with a normal ECG. This knowledge is of importance, and may be used in a clinical algorithm, in identifying patients that should be followed and investigated extensively for the presence of CS.

【 授权许可】

   
2014 Darlington et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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