Impact of Parenchymal Lung Disease in Echocardiographic Estimate of Pulmonary Artery Pressure in Sarcoidosis Patients

Huitema, Marloes P.; Post, Martijn C.; Grutters, Jan C.; Kouranos, Vasileios; Shlobin, Oksana A.; Nathan, Steven D.; Wells, Athol U.; Culver, Daniel A.; Barney, Joseph B.; Gupta, Rohit; Porquera, Eva M. Carmona; Alhamad, Esam H.; Scholand, Mary Beth; Wijsenbeek, Marlies; Ganesh, Sivagini; Lower, E.E.; Baughman, Robert P.; Engel, PJ

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a5081

Cited by 3 publications

(3 citation statements)

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“…A multi-national study based on ReSAPH, PULSAR and the Cincinnati Sarcoid Clinic database evaluated 124 patients with an RHC-confirmed SAPH [77]. It showed a strong correlation between right ventricular systolic pressure (RVSP) and pulmonary artery systolic pressure (PASP) in patients with a FVC > 60% pred, less significant in those with a FVC < 50% pred.…”

Section: Ttementioning

confidence: 99%

Sarcoidosis-Associated Pulmonary Hypertension

Israël-Biet,

Pastré,

Nunes

2024

JCM

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Sarcoidosis-associated pulmonary hypertension (SAPH) is a very severe complication of the disease, largely impacting its morbidity and being one of its strongest predictors of mortality. With the recent modifications of the hemodynamic definition of pulmonary hypertension (mean arterial pulmonary pressure >20 instead of <25 mmHg,) its prevalence is presently not precisely known, but it affects from 3 to 20% of sarcoid patients; mostly, although not exclusively, those with an advanced, fibrotic pulmonary disease. Its gold-standard diagnostic tool remains right heart catheterization (RHC). The decision to perform it relies on an expert decision after a non-invasive work-up, in which echocardiography remains the screening tool of choice. The mechanisms underlying SAPH, very often entangled, are crucial to define, as appropriate and personalized therapeutic strategies will aim at targeting the most significant ones. There are no recommendations so far as to the indications and modalities of the medical treatment of SAPH, which is based upon the opinion of a multidisciplinary team of sarcoidosis, pulmonary hypertension and sometimes lung transplant experts.

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Section: Ttementioning

confidence: 99%

Sarcoidosis-Associated Pulmonary Hypertension

Israël-Biet,

Pastré,

Nunes

2024

JCM

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“…The estimated systolic pressure of the pulmonary artery, in echocardiography, showed correlation with the measurements shown by the right catheterization in patients with pulmonary sarcoidosis. 11 Peak…”

Section: Conventional Echocardiography Evaluationmentioning

confidence: 99%

What Is Important in the Echocardiographic Evaluation of Patients With Cardiac Sarcoidosis?

Santorio,

Fernandes

et al. 2023

ABC Imagem Cardiovascular

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Sarcoidosis is a systemic condition, of unclear etiology, associated with the formation of non-necrotizing granulomas in several organs, and thoracic involvement in 90% of the cases. Cardiac impairment is detected in approximately 10% of the patients, reaching 25% in autopsy studies. It is in charge of about half the deaths in patients with sarcoidosis, and an important prognostic factor. Interventricular septum and the left ventricle free wall are the most affected regions, especially in the subepicardial portion. The development of changes in conduction (including atrioventricular block and ventricular arrhythmia) and heart failure are the most common manifestations. Diagnosis is challenging and often requires more advanced imaging examinations, such as positron emission tomography or late-enhancement cardiac magnetic resonance imaging. However, these examinations have high cost and are not so available. The conventional transthoracic echocardiography, on the other hand, is widely accessible, but presents later and little specific findings. The most important ones are the reduction of the left ventricle ejection fraction < 50% and the presence of abnormal tapering of the basal interventricular septum. Other segmental changes, especially when not correspondent to coronary territories, and aneurisms, are also relevant. Besides, there may be diastolic dysfunction, pericardial effusion and right ventricular dysfunction, both due to impairment primary or secondary to pulmonary hypertension. The most advanced ultrasound techniques, such as myocardial strain, myocardial work and elastography, are promising in the search of an earlier diagnosis at a lower cost.

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“…A estimativa da pressão sistólica da artéria pulmonar pelo ecocardiograma mostrou correlação com as medidas realizadas por cateterismo direito em pacientes com sarcoidose pulmonar. 11 Velocidades máximas de refluxo tricúspide < 2,9 m/s foram acuradas para exclusão de hipertensão pulmonar nesses pacientes, enquanto valores > 3,4 m/s aumentam consideravelmente a probabilidade de hipertensão pulmonar pela medida invasiva. 12 Na figura central, são representados os principais achados ecocardiográficos associados à sarcoidose cardíaca.…”

Section: Santorio Et Al Avaliação Ecocardiográfica Na Sarcoidose Card...unclassified

O Que É Importante na Avaliação Ecocardiográfica do Paciente Com Sarcoidose Cardíaca?

Santorio,

Fernandes

et al. 2023

Arq Bras Cardiol: Imagem cardiovasc.

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A sarcoidose é uma doença sistêmica, de etiologia não esclarecida, associada à formação de granulomas não necrotizantes em diversos órgãos, com envolvimento torácico em 90% dos casos. O acometimento cardíaco é detectado em aproximadamente 10% dos pacientes, chegando a 25% nos estudos de autópsia. É responsável por cerca de metade dos óbitos em pacientes com sarcoidose, sendo importante fator prognóstico. O septo interventricular e a parede livre do ventrículo esquerdo são as regiões mais acometidas, especialmente na porção subepicárdica. O desenvolvimento de alterações de condução (incluindo bloqueios atrioventriculares e arritmias ventriculares) e insuficiência cardíaca são as manifestações mais comuns. O diagnóstico é desafiador e exige, na maioria dos casos, a realização de exames de imagem avançados, como a tomografia por emissão de pósitrons ou ressonância magnética cardíaca com técnica de realce tardio. Porém, são exames de custo elevado e pouco disponíveis. O ecocardiograma transtorácico convencional, por outro lado, é amplamente acessível, mas apresenta achados mais tardios e pouco específicos. Os mais importantes são a redução da fração de ejeção ventricular esquerda < 50% e a presença de afilamento anormal do septo interventricular basal. Outras alterações segmentares, especialmente quando não correspondentes a territórios coronarianos, e aneurismas, também são de grande relevância. Além disso, podem estar presentes disfunção diastólica, derrame pericárdico e disfunção ventricular direita, tanto por acometimento primário como secundário à hipertensão pulmonar. As técnicas ultrassonográficas mais avançadas, como o strain miocárdico, trabalho miocárdico e elastografia, são promissoras na busca de um diagnóstico mais precoce e de menor custo.

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Impact of Parenchymal Lung Disease in Echocardiographic Estimate of Pulmonary Artery Pressure in Sarcoidosis Patients

Cited by 3 publications

References 0 publications

Sarcoidosis-Associated Pulmonary Hypertension

Sarcoidosis-Associated Pulmonary Hypertension

What Is Important in the Echocardiographic Evaluation of Patients With Cardiac Sarcoidosis?

O Que É Importante na Avaliação Ecocardiográfica do Paciente Com Sarcoidose Cardíaca?

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