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

Abstract

Although impaired LV diastolic function was detected using conventional parameters, only novel advanced echocardiographic modalities demonstrated impaired bi-ventricular and atrial mechanical functions in patients with sarcoidosis.

Improved detection of myocardial damage in sarcoidosis using longitudinal strain in patients with preserved left ventricular ejection fraction

“…Our study expands on recent publications that have suggested that indices of myocardial deformation, such as GLS, are abnormal in the presence of CS, 34 Based on the work of Orii et al, 13 we understand that in patients with extra-cardiac sarcoidosis, reduction in regional longitudinal strain is related to the presence of LGE in myocardial segments. We also found that the abnormalities in GLS are not only associated with the presence of LGE, but also with the burden of LGE seen on CMR.…”

“…There is clearly a need for identifying other TTE parameters that may increase its sensitivity for the detection of CS. Our study expands on recent publications that have suggested that indices of myocardial deformation, such as GLS, are abnormal in the presence of CS, even when other TTE parameters are within normal limits. Similarly, others have reported reduced radial 3D strain in CS patients when compared to individuals with dilated cardiomyopathy with matched LV EF …”

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).…”

Atrial Arrhythmias and Atrial Involvement in Cardiac Sarcoidosis

“…It has been speculated that atrial arrhythmias in CS are caused by inflammation or scar formation associated with atrial sarcoidosis, or by atrial overload secondary to ventricular dysfunction or pulmonary lesions. [11][12][13][14] Viles-Gonzalez, et al conducted a multivariate analysis and concluded that left atrial enlargement was the only independent factor associated with atrial arrhythmias in patients with CS. 8) Abeler has described a case of sudden death due to cardiac arrest caused by granulomatous lesions in the sinus node.…”