Satomi Nagao1, Hiroshi Watanabe2, Yoshihiro Sobue3, Makoto Kodama2, Junichi Tanaka4, Naohito Tanabe5, Eiichi Suzuki4, Ichiei Narita4, Eiichi Watanabe3, Yoshifusa Aizawa2, Tohru Minamino2. 1. Division of Cardiology, Niigata University Hospital, Niigata, Japan. Electronic address: peachberryapricotcandy@gmail.com. 2. Division of Cardiology, Niigata University Hospital, Niigata, Japan. 3. Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan. 4. Division of Respiratory Medicine, Niigata University Hospital, Niigata, Japan. 5. Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata, Japan.
Abstract
BACKGROUND: Cardiac involvement is a leading cause of death from sarcoidosis. Because the efficacy of corticosteroid treatment is limited in patients with cardiac manifestation, early diagnosis is important. However, cardiac involvement is difficult to identify at early stages and is often underdiagnosed. Therefore, this study aimed to identify electrocardiographic risk factors for cardiac events in patients with extracardiac sarcoidosis. METHODS: This prospective observational cohort study included 227 patients with extracardiac sarcoidosis who did not have any cardiac manifestation (age, 49 ± 17 years; women, 63%). We studied the association of electrocardiographic abnormalities with developing cardiac manifestations. RESULTS: During a follow-up of 6.3 ± 3.7 years, 11 patients developed cardiac events, including advanced atrioventricular block (4 patients), ventricular tachycardia (4 patients), and systolic dysfunction (3 patients). All patients had electrocardiographic abnormalities prior to the development of cardiac events. In multivariate analyses, the baseline heart rate and PR interval were associated with increased risk of developing cardiac events. The QRS duration and corrected QT interval were not associated with cardiac manifestations. The multivariate analyses also revealed that baseline conduction disorder, ST segment/T wave abnormalities, and fragmented QRS complexes were associated with cardiac events. CONCLUSIONS: Electrocardiographic abnormalities occurred prior to cardiac events in extracardiac sarcoidosis. Patients with electrocardiographic abnormalities may require further evaluation for cardiac involvement and careful follow-up.
BACKGROUND:Cardiac involvement is a leading cause of death from sarcoidosis. Because the efficacy of corticosteroid treatment is limited in patients with cardiac manifestation, early diagnosis is important. However, cardiac involvement is difficult to identify at early stages and is often underdiagnosed. Therefore, this study aimed to identify electrocardiographic risk factors for cardiac events in patients with extracardiac sarcoidosis. METHODS: This prospective observational cohort study included 227 patients with extracardiac sarcoidosis who did not have any cardiac manifestation (age, 49 ± 17 years; women, 63%). We studied the association of electrocardiographic abnormalities with developing cardiac manifestations. RESULTS: During a follow-up of 6.3 ± 3.7 years, 11 patients developed cardiac events, including advanced atrioventricular block (4 patients), ventricular tachycardia (4 patients), and systolic dysfunction (3 patients). All patients had electrocardiographic abnormalities prior to the development of cardiac events. In multivariate analyses, the baseline heart rate and PR interval were associated with increased risk of developing cardiac events. The QRS duration and corrected QT interval were not associated with cardiac manifestations. The multivariate analyses also revealed that baseline conduction disorder, ST segment/T wave abnormalities, and fragmented QRS complexes were associated with cardiac events. CONCLUSIONS: Electrocardiographic abnormalities occurred prior to cardiac events in extracardiac sarcoidosis. Patients with electrocardiographic abnormalities may require further evaluation for cardiac involvement and careful follow-up.
Authors: Lynda E Rosenfeld; Mina K Chung; Clifford V Harding; Paolo Spagnolo; Johan Grunewald; Jason Appelbaum; William H Sauer; Daniel A Culver; Jose A Joglar; Ben A Lin; Christine L Jellis; Timm-Michael Dickfeld; Deborah H Kwon; Edward J Miller; Paul C Cremer; Frank Bogun; Jordana Kron; Ashley Bock; Davendra Mehta; Paul Leis; Konstantinos C Siontis; Elizabeth S Kaufman; Thomas Crawford; Peter Zimetbaum; Edwin T Zishiri; Jagmeet P Singh; Kenneth A Ellenbogen; Jonathan Chrispin; Syed Quadri; Logan L Vincent; Kristen K Patton; Steven Kalbfleish; Thomas D Callahan; Francis Murgatroyd; Marc A Judson; David Birnie; David R Okada; Christopher Maulion; Pavan Bhat; Lavanya Bellumkonda; Ron Blankstein; Richard K Cheng; Maryjane A Farr; Jerry D Estep Journal: Circ Arrhythm Electrophysiol Date: 2021-02-16
Authors: Magdalena M Martusewicz-Boros; Piotr W Boros; Elżbieta Wiatr; Jacek Zych; Dorota Piotrowska-Kownacka; Kazimierz Roszkowski-Śliż Journal: Medicine (Baltimore) Date: 2016-08 Impact factor: 1.889
Authors: Elliott D Crouser; Lisa A Maier; Kevin C Wilson; Catherine A Bonham; Adam S Morgenthau; Karen C Patterson; Eric Abston; Richard C Bernstein; Ron Blankstein; Edward S Chen; Daniel A Culver; Wonder Drake; Marjolein Drent; Alicia K Gerke; Michael Ghobrial; Praveen Govender; Nabeel Hamzeh; W Ennis James; Marc A Judson; Liz Kellermeyer; Shandra Knight; Laura L Koth; Venerino Poletti; Subha V Raman; Melissa H Tukey; Gloria E Westney; Robert P Baughman Journal: Am J Respir Crit Care Med Date: 2020-04-15 Impact factor: 21.405