Diagnostic Value of Strain Echocardiography, Galectin-3, and Tenascin-C Levels for the Identification of Patients with Pulmonary and Cardiac Sarcoidosis

Abstract

PS patients demonstrate reduced cardiac contractility, independent of CMR-proven structural cardiac lesions, while patients with structural lesions have a more pronounced drop in strain parameters. Tn-C and Gl-3 are promising markers for the diagnosis of PS, but they are not specific for cardiac involvement.

Early Detection of Bi-ventricular and Atrial Mechanical Dysfunction Using Two-Dimensional Speckle Tracking Echocardiography in Patients with Sarcoidosis

“…In our study, we demonstrated that LV GLS, twist, and untwist were lower in sarcoidosis patients compared to controls, suggesting early subclinical cardiac involvement. Kul et al [22] showed that patients with pulmonary sarcoidosis have reduced cardiac contractility, independent of structural cardiac lesions observed through cardiac magnetic resonance imaging (CMRI), while patients with structural lesions have a more pronounced drop in strain parameters. However, these authors only used LV longitudinal and circumferential strain parameters for the evaluation of LV functions using 2D STE.…”

JCS 2016 Guideline on Diagnosis and Treatment of Cardiac Sarcoidosis ― Digest Version ―

“…In addition to commonly used staining procedures such as hematoxylin-eosin (HE) staining, immunostaining procedures using antibodies to macrophages and other inflammatory cells, P. acnes, and tenascin C (an extracellular matrix protein) are used in diagnosing pulmonary sarcoidosis or differentiating it from other diseases 63,247 (Evidence level 4b, Recommendation grade C1).…”

A joint procedural position statement on imaging in cardiac sarcoidosis: from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology

“…Echocardiographic features of cardiac sarcoidosis echo can also mimic arrhythmogenic right ventricular dysplasia/cardiomyopathy. 25,26 In the early stage of the disease, reduced longitudinal myocardial function (2D speckle tracking or tissue Doppler imagingderived strain) [27][28][29][30][31][32] or alterations in acoustic properties of the myocardium, 33,34 particularly in the basal interventricular septum, may be present in the absence of other 2D echo features. About 20% of patients with cardiac sarcoidosis have atrial lesions characterized by atrial wall hypertrophy (easier diagnosis by transoesophageal echocardiography).…”