2nd Department of Medicine, Department of Cardiovascular Medicine, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
1st Department of Tuberculosis and Respiratory Diseases, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic.
Kardiol Pol. 2022;80(9):897-901. doi: 10.33963/KP.a2022.0163. Epub 2022 Jul 1.
Sarcoidosis is a systemic inflammatory disease of unknown etiology, which can affect almost any organ. Cardiac involvement determines the prognosis of the affected individuals. Its prevalence in patients with extracardiac sarcoidosis with the absence of cardiac symptoms remains unclear. Cardiac magnetic resonance (CMR) provides excellent diagnostic accuracy in the detection of heart involvement by sarcoidosis.
We sought to determine the prevalence of cardiac sarcoidosis in asymptomatic individuals with newly diagnosed extracardiac sarcoidosis using CMR.
We prospectively evaluated 55 consecutive patients including 23 women with newly diagnosed extracardiac sarcoidosis who underwent contrast-enhanced CMR and had no symptoms of heart disease. The mean (standard deviation) age of patients was 43 (11) years. The presence of myocardial late gadolinium enhancement (LGE) of non-ischemic etiology on CMR examination was considered diagnostic for cardiac sarcoidosis.
In 3 (6%) patients, the LGE pattern consistent with cardiac sarcoidosis was detected. In all patients, preserved left ventricular systolic regional and global function was present, and in none of them, the elevation of blood biomarkers of myocardial injury or overload was found.
Our study suggests that the prevalence of cardiac involvement in patients with newly diagnosed extracardiac sarcoidosis and no symptoms of heart disease is very low as assessed by CMR. However, CMR may be considered as part of routine evaluation of patients with extracardiac sarcoidosis due to its higher diagnostic yield in comparison with echocardiography and electrocardiography, respectively.
结节病是一种病因不明的全身性炎症性疾病，几乎可影响任何器官。心脏受累决定了受影响个体的预后。在无心脏症状的心脏外结节病患者中，其心脏受累的患病率尚不清楚。心脏磁共振（CMR）在检测结节病引起的心脏受累方面具有出色的诊断准确性。
我们旨在通过 CMR 确定无症状的新发心脏外结节病患者中心脏结节病的患病率。
我们前瞻性评估了 55 例连续患者，包括 23 名女性新发心脏外结节病患者，这些患者接受了对比增强 CMR 检查且无心脏病症状。患者的平均（标准差）年龄为 43（11）岁。CMR 检查中存在非缺血性病因的心肌延迟钆增强（LGE）被认为是心脏结节病的诊断依据。
在 3（6%）例患者中，检测到与心脏结节病一致的 LGE 模式。所有患者均存在左心室收缩区域性和整体功能保留，且均未发现心肌损伤或超负荷的血液生物标志物升高。
我们的研究表明，在通过 CMR 评估无心脏病症状的新发心脏外结节病患者中，心脏受累的患病率非常低。然而，与心电图和超声心动图相比，CMR 的诊断效能更高，因此可考虑将其作为心脏外结节病患者常规评估的一部分。
