Prognostic value of delayed enhancement cardiovascular magnetic resonance in patients with sarcoidosis
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KeywordsCongenital Heart Disease Sarcoidosis Heart Transplant Major Adverse Cardiac Event Cardiac Involvement
Although sudden death is a leading cause of mortality in patients with sarcoidosis, cardiac involvement is often unrecognized clinically. Delayed enhancement cardiovascular magnetic resonance (DE-CMR) has been shown to detect cardiac involvement in patients with sarcoidosis. We sought to evaluate the prognostic value of myocardial sarcoid involvement by DE-CMR.
Consecutive patients with biopsy proven extracardiac sarcoidosis or suspected isolated cardiac sarcoidosis were prospectively recruited. Patients with history of cardiac surgery, heart transplant, documented coronary artery disease, congenital heart disease were excluded. Of the 251 meeting criteria, 231 participants were enrolled (18 declined consent, 2 were minors) underwent CMR, and followed for 2.7±2.2 years for major adverse cardiac events (cardiac death, appropriate defibrillator shock, pacemaker placement, or heart transplantation). CMR images were analyzed by a consensus of two experienced readers who where blinded to all other data.
In patients with sarcoidosis, myocardial involvement by DE-CMR is the strongest independent predictor of adverse cardiac prognosis.
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