Bayat Fariba, Fahimi Asieh, Tavana Sasan, Tabary Mohammadreza, Khaheshi Isa
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pulmonary Medicine, Clinical Research and Development Center, Shahid Modarres Hospital, Tehran, Iran.
Echocardiography. 2020 Jan;37(1):41-46. doi: 10.1111/echo.14572. Epub 2020 Jan 15.
Cardiac involvement by sarcoidosis may affect any part of the heart such as the pericardium, atriums, ventricles, and papillary muscles. In this regard, the use of two-dimensional speckle-tracking strain has been reported to be valuable in detecting heart sarcoidosis and its distinction from cardiomyopathy. The aim of this study was to investigate subclinical cardiac involvement using 2D speckle tracking and its associated factors in patients with normal systolic function by 2D transthoracic echocardiography (TTE).
In this study, 55 patients with extra-cardiac sarcoidosis and 21 normal people were evaluated by 2D speckle tracking. The mean longitudinal global strain for the left ventricle was calculated as an average of 16 segments per patient.
The comparison of the mean 2D speckle-tracking indices including GCS (global circumferential strain) SAXA, GCSSAXM, Average GCS, AP2LS, AP3LS, AP4LS, and also Average GLS (global longitudinal strain) showed a significant difference between the two groups. Also, the evaluation of each of the above indices with a specific cutoff point as well as a high sensitivity and acceptable specificity predicted the presence of sarcoidosis. The occurrence of changes in the above indices was independent of ventricular function by 2D echocardiography in these patients.
The marked changes in the 2D speckle-tracking parameters in patients with extra-cardiac sarcoidosis can be of great value in the prediction of cardiac involvement. The occurrence of the abovementioned cardiac changes can be completely independent of the involvement of left ventricular function and is therefore predictable in patients with normal ventricular function.
结节病累及心脏时可影响心脏的任何部位，如心包、心房、心室和乳头肌。在这方面，二维斑点追踪应变已被报道在检测心脏结节病及其与心肌病的鉴别中具有重要价值。本研究的目的是通过二维经胸超声心动图（TTE），利用二维斑点追踪技术研究收缩功能正常的患者亚临床心脏受累情况及其相关因素。
本研究中，55例心脏外结节病患者和21名正常人接受了二维斑点追踪评估。计算左心室的平均纵向整体应变，作为每位患者16个节段的平均值。
比较包括GCS（整体圆周应变）SAXA、GCSSAXM、平均GCS、AP2LS、AP3LS、AP4LS以及平均GLS（整体纵向应变）在内的二维斑点追踪指标平均值，两组之间存在显著差异。此外，以特定临界值以及高敏感性和可接受的特异性对上述每个指标进行评估，可预测结节病的存在。在这些患者中，上述指标变化的发生与二维超声心动图显示的心室功能无关。
心脏外结节病患者二维斑点追踪参数的显著变化在预测心脏受累方面可能具有重要价值。上述心脏变化的发生可能完全独立于左心室功能受累情况，因此在心室功能正常的患者中是可预测的。
