Jain Hritvik, Shahzad Maryam, Usman Muhammad, Kc Anil, Singh Jagjot, Jain Jyoti, Odat Ramez M, Goyal Aman, Ahmed Faizan, Ahmed Raheel
Department of Cardiology, All India Institute of Medical Sciences, Jodhpur 342005, India.
Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan.
Diagnostics (Basel). 2025 Feb 20;15(5):518. doi: 10.3390/diagnostics15050518.
Sarcoidosis is a multisystem disorder characterized by non-caseating granulomas in various organs. While cardiac sarcoidosis (CS) is clinically rare, it has significant implications, including heart failure, ventricular arrhythmias, and sudden cardiac death. Speckle-tracking echocardiography has emerged as a promising tool for detecting subclinical myocardial dysfunction, which is cost-efficient and readily available. This meta-analysis aims to evaluate differences in functional echocardiographic parameters between patients with CS and extracardiac sarcoidosis (ECS) to improve early recognition and management. A comprehensive search of major bibliographic databases was conducted to identify studies up to December 2024. Mean differences (MDs) with 95% CIs were pooled using the inverse-variance random-effect model. Seven studies with 478 patients with sarcoidosis (CS: 159 and ECS: 319) were included. Patients with CS had a significant reduction in left ventricular global longitudinal strain (MD: -2.73; 95% CI: -4.09, -1.38; < 0.0001) and tricuspid annular plane systolic excursion (MD: -0.59; 95% CI: -1.12, -0.05; = 0.03) compared to patients with ECS. No significant differences in the LV global circumferential strain, interventricular septum thickness, left ventricular ejection fraction, E/A ratio, E/E' ratio, LV end-diastolic diameter, and LV end-systolic diameter were noted. LV GLS and TAPSE are promising parameters for the early detection of cardiac involvement in sarcoidosis, with significant prognostic implications. Although STE provides a cost-effective and accessible alternative to CMR and FDG-PET, further research is needed to standardize its use and validate diagnostic cut-offs.
结节病是一种多系统疾病，其特征是各器官出现非干酪样肉芽肿。虽然心脏结节病（CS）在临床上较为罕见，但它具有重大影响，包括心力衰竭、室性心律失常和心源性猝死。斑点追踪超声心动图已成为检测亚临床心肌功能障碍的一种有前景的工具，它具有成本效益且易于获得。这项荟萃分析旨在评估CS患者与心脏外结节病（ECS）患者在超声心动图功能参数上的差异，以改善早期识别和管理。对主要文献数据库进行了全面检索，以识别截至2024年12月的研究。使用逆方差随机效应模型汇总95%置信区间的平均差异（MDs）。纳入了7项研究，共478例结节病患者（CS：159例，ECS：319例）。与ECS患者相比，CS患者的左心室整体纵向应变（MD：-2.73；95%置信区间：-4.09，-1.38；<0.0001）和三尖瓣环平面收缩期位移（MD：-0.59；95%置信区间：-1.12，-0.05；=0.03）显著降低。左心室整体圆周应变、室间隔厚度、左心室射血分数、E/A比值、E/E'比值、左心室舒张末期直径和左心室收缩末期直径未发现显著差异。左心室整体纵向应变和三尖瓣环平面收缩期位移是早期检测结节病心脏受累的有前景的参数，具有重要的预后意义。虽然斑点追踪超声心动图为心脏磁共振成像和氟代脱氧葡萄糖正电子发射断层扫描提供了一种具有成本效益且易于获得的替代方法，但仍需要进一步研究来规范其使用并验证诊断临界值。
