Global longitudinal strain and long‐term outcomes in asymptomatic extracardiac sarcoid patients with no apparent cardiovascular disease

Felekos, Ioannis; Aggeli, Constantina; Gialafos, Elias; Kouranos, Vasileios; Rapti, Aggeliki; Sfikakis, Petros P.; Koulouris, Nikolaos; Tousoulis, Dimitris

doi:10.1111/echo.13846

Cited by 21 publications

(26 citation statements)

References 19 publications

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“…Nine studies reported LVGLS in our cohorts. 10,[15][16][17][18][19][20][21][22] The pooled mean LVGLS was significantly lower in the sarcoid group as compared with controls: standard mean difference (SMD) −3.98, 95%…”

Section: Re Sultsmentioning

confidence: 99%

“…Of these, 28 full texts were screened and 9 studies were included in the final analysis with an aggregate of 967 patients: 589 in the sarcoid group and 378 in the control group. 10,[15][16][17][18][19][20][21][22] patients with cardiovascular symptoms. 23 The study flow chart is presented in Figure 1.…”

Section: Re Sultsmentioning

confidence: 99%

“…10,16,17,19 In patients with sarcoidosis, MCEs were reported in 4 stud- Figure S1). 20,21,23 Using the NOS tool to evaluate the risk of bias, out of 9 stars, all studies were awarded 8-9 stars and can be described as "moderate to high" in quality. The risk of bias of individual studies is reported in Table 4.…”

Section: Lvgcs Was Reported In 4 Studies With a Total Of 266 Patientsmentioning

confidence: 99%

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Speckle tracking echocardiography can predict subclinical myocardial involvement in patients with sarcoidosis: A meta‐analysis

et al. 2020

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Background: This meta-analysis aims to evaluate the utility of speckle tracking echocardiography (STE) as a tool to evaluate for cardiac sarcoidosis (CS) early in its course. Electrocardiography and echocardiography have limited sensitivity in this role, while advanced imaging modalities such as cardiac magnetic resonance (CMR) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) are limited by cost and availability. Methods: We compiled English language articles that reported left ventricular global longitudinal strain (LVGLS) or global circumferential strain (GCS) in patients with confirmed extra-cardiac sarcoidosis versus healthy controls. Studies that exclusively included patients with probable or definite CS were excluded. Continuous data were pooled as a standard mean difference (SMD), comparing sarcoidosis group with healthy controls. A random-effect model was adopted in all analyses. Heterogeneity was assessed using Q and I2 statistics. Results: Nine studies were included in our final analysis with an aggregate of 967 patients. LVGLS was significantly lower in the extra-cardiac sarcoidosis group as compared with controls, SMD −3.98, 95% confidence interval (CI): −5.32, −2.64, P < .001, also was significantly lower in patients who suffered major cardiac events (MCE), −3.89, 95% CI −6.14, −1.64, P < .001. GCS was significantly lower in the extra-cardiac sarcoidosis group as compared with controls, SMD: −3.33, 95% CI −4.71, −1.95, P < .001. Conclusion: LVGLS and GCS were significantly lower in extra-cardiac sarcoidosis patients despite not exhibiting any cardiac symptoms. LVGLS correlates with MCEs in CS. Further studies are required to investigate the role of STE in the early screening of CS.

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Section: Re Sultsmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%

Section: Lvgcs Was Reported In 4 Studies With a Total Of 266 Patientsmentioning

confidence: 99%

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Speckle tracking echocardiography can predict subclinical myocardial involvement in patients with sarcoidosis: A meta‐analysis

et al. 2020

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“…Global longitudinal strain has been shown to be reduced in patients with extra-cardiac sarcoidosis but without overt evidence of cardiac involvement, indicating pre-clinical cardiac involvement prior to any reduction in LVEF or other ECG/echocardiographic abnormalities [46,47] (Figure 5). Moreover, this reduction in GLS has also been associated with poorer outcomes, including all-cause mortality, heart failure hospitalisation and malignant ventricular arrhythmias [46][47][48][49]. Furthermore, GLS is able to differentiate between patients with extra-cardiac (À19.6 AE 1.9%) and cardiac sarcoid (À14.7 AE 2.4%) with virtually no overlap between the two groups [50].…”

Section: Advanced Echocardiographic Imagingmentioning

confidence: 99%

Echocardiography in Infiltrative Cardiomyopathy

Perry

Selvanayagam

2019

Heart, Lung and Circulation

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Left ventricular (LV) wall thickening can occur due to both physiological and pathological processes. Some LV wall thickening is caused by infiltrative cardiac deposition diseases-rare disorders from both inherited and acquired conditions, with varying systemic manifestations. They portend a poor prognosis and are generally not reversible except in rare circumstances when early diagnosis and treatment may alter the outcome (e.g., Fabry disease). Cardiac involvement is variable and depends on the degree of infiltration and type of infiltrate. These changes often lead to the development of abnormalities in both the relaxation and contractile function of the heart ultimately resulting in heart failure. Echocardiography is generally the first investigation of choice as it is easily available and gives valuable information about the thickness of the ventricular walls as well as systolic and diastolic function. It is also able to identify unique, characteristic features of the disease as well as detecting any haemodynamic sequelae. This review looks at the role of echocardiography in the diagnosis and prognosis of infiltrative cardiac deposition diseases.

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“…Potential novel approaches to monitoring cardiac sarcoidosis include global longitudinal strain detected by echocardiography [7], serum biomarkers of cardiac injury [8][9][10][11], and miniaturized insertable cardiac monitors. However, currently there are inadequate data to recommend any of these approaches for monitoring cardiac sarcoidosis.…”

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confidence: 99%

Monitoring cardiac sarcoidosis: The next frontier

Judson

2018

Respiratory Medicine

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Global longitudinal strain and long‐term outcomes in asymptomatic extracardiac sarcoid patients with no apparent cardiovascular disease

Abstract: In conclusion, among patients with extracardiac sarcoidosis and no symptoms of cardiovascular disease, even when EF is preserved, GLS seems to be strongly associated with adverse future events.

Cited by 21 publications

References 19 publications

Speckle tracking echocardiography can predict subclinical myocardial involvement in patients with sarcoidosis: A meta‐analysis

Speckle tracking echocardiography can predict subclinical myocardial involvement in patients with sarcoidosis: A meta‐analysis

Echocardiography in Infiltrative Cardiomyopathy

Monitoring cardiac sarcoidosis: The next frontier

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