Pneumologie 2017; 71(S 01): S1-S125
DOI: 10.1055/s-0037-1598398
Posterbegehung – Sektion Kardiorespiratorische Interaktion
Herz – Gefäße – Lunge: Interaktionen und Kasuistiken – Hans-Jürgen Seyfarth/Leipzig, Jörg Friedrich/Heidelberg
Georg Thieme Verlag KG Stuttgart · New York

Speckle-tracking echocardiography for diagnosis of cardiac sarcoidosis: Correlation with CMR

C Pizarro
1  Universitätsklinikum Bonn
,
F Klünker
1  Universitätsklinikum Bonn
,
D Dabir
1  Universitätsklinikum Bonn
,
C Hammerstingl
1  Universitätsklinikum Bonn
,
G Nickenig
2  Medizinische Klinik II, Universitätsklinikum Bonn
,
D Skowasch
2  Medizinische Klinik II, Universitätsklinikum Bonn
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2017 (online)

 

Background:

Given the heterogeneity of sarcoidosis per se and cardiac sarcoidosis (CS) in particular, major efforts are undertaken to identify imaging modalities that allow for a reliable and timely CS diagnosis. With the intent to define its validity for the diagnosis of cardiac sarcoidal affection, we performed offline speckle tracking analysis of both CS-positive and CS-negative patients.

Methods:

Study population comprised 60 patients (47.8 ± 11.4yrs, 51.7% male) with histologically proven sarcoidosis of whom 19 patients offered cardiac sarcoid involvement, whereas the remaining 41 patients absented cardiac affection. CS-presence and absence were defined on the basis of prior cardiovascular magnetic resonance (CMR) imaging. At the time of CMR-conduction, patients underwent complementary 2D transthoracic echocardiography.

Results:

Evaluation of global and regional biventricular deformation properties derived from 2D longitudinal strain imaging revealed impairment of longitudinal performance in CS-positive patients as compared to CS-negative individuals. Concretely, the left ventricular global, medial septal and apical septal longitudinal strains were significantly reduced in and correlate with CS-presence (p = 0.009, p = 0.007, p = 0.02, respectively). Comparative ROC analysis identified the left ventricular global longitudinal strain to have the highest predicted value for CS presence: the area under the curve accounted for 0.72 (95% CI: 0.56 – 0.87; p < 0.01) and was indicative of an overall fair accuracy. A cut-off value of -14.1% showed a sensitvity of 73.7% and a specificity of 73.2%. In contrast to the left ventricular strains, none of the right ventricular deformation values evidenced correlation with CS-status.

Conclusion:

Speckle tracking analysis identified cardiac affection to correlate with reduction in left ventricular longitudinal deformation capabilities and might be an appropriate tool for timely CS-diagnosing and disease's monitoring.