Doppler Echocardiographic Detection of Left Ventricular Diastolic Dysfunction in Patients With Pulmonary Sarcoidosis

Evaluation of Known or Suspected Cardiac Sarcoidosis

“…18 Indeed, echocardiographic abnormalities (Figure 1) have been reported in 14% to 46% of patients with systemic sarcoidosis, even in the absence of symptoms or ECG abnormalities. [19][20][21][22][23] Abnormal findings include wall motion abnormalities, diastolic dysfunction, abnormal myocardial wall thickness in a noncoronary distribution, possibly caused by sarcoid granulomas, or thinning, as a late result of the same process. [20][21][22] In addition, findings of left ventricular dilatation and left ventricular systolic dysfunction, which can be assessed by echocardiography, are predictors of mortality in CS 6,21 Despite the various abnormalities that can be identified by echocardiography, patients with CS may have a normal echocardiogram, and accordingly echocardiography has a low sensitivity to diagnose early or localized mild disease.…”

Caso 5: mulher de 50 anos com cardiomiopatia restritiva, insuficiência renal e proteinúria

“…Nevertheless, false negative results may occur due because the attack is not homogeneous, mainly in heart diseases 16 . What is against the diagnosis of cardiac sarcoidosis in this patient is the presence of septal hyperrefringency in the TTE, as in sarcoidosis, alterations are not specific and may include ventricular aneurism, cavity dilation and wall thickening 17 .…”

Sarcoidosis and the heart: A review of the literature

“…A previous retrospective study reported that Doppler echocardiography was abnormal in 67% of patients, with abnormalities that included dilated cardiomyopathy (32%), abnormal left ventricular relaxation (29%), and diffuse or localized dyskinesia or hypokinesia (26%) (1,53). A previous study reported that 14% of patients with pulmonary sarcoidosis without known cardiac involvement had diastolic dysfunction as a result of CS (68). A prolonged isovolumic relaxation time and a reversed E/A Doppler ratio are the most common echocardiographic patterns of diastolic dysfunction seen in early CS (68).…”

“…ECG was reported to have a sensitivity of 33% to 58% and a specificity of 22% to 71% at detecting CS (53,54). ECG abnormalities like conduction disturbances, arrhythmia, or nonspecific ST and T-wave changes have been detected in 20 to 31% of patients with sarcoidosis (10,(55)(56)(57)). An autopsy study of sarcoidosis with mild (microscopically evident granulomas) and severe (gross evidence of cardiac granulomas or infiltration at autopsy) cardiac involvement reported finding arrhythmia in 42% of patients and conduction disturbances in 75% of patients (10).…”

“…A previous study reported that 14% of patients with pulmonary sarcoidosis without known cardiac involvement had diastolic dysfunction as a result of CS (68). A prolonged isovolumic relaxation time and a reversed E/A Doppler ratio are the most common echocardiographic patterns of diastolic dysfunction seen in early CS (68). Although these Doppler findings have some role in diagnosing CS and determining its prognosis, they lack the sensitivity and specificity to detect early cardiac involvement (7).…”