Abstract 14851: Early Detection of Cardiac Sarcoidosis: A Multimodality Imaging Approach
Background: Speckle tracking and late gadolinium enhancement cardiac MRI (LGE-CMR) have revolutionised the understanding of myocardial function . The aim of this study was to evaluate left ventricular (LV) function in patients with newly diagnosed sarcoidosis, utilizing the novel method of 2D speckle tracking and validate our findings with those of the LGE-CMR.
Methods: 41 patients with newly-diagnosed sarcoidosis and with unremarkable medical history of cardiovascular disease, as well as 20 healthy age- and gender-matched controls underwent echocardiographic study. Moreover, the patient group underwent LGE-CMR. Apical 4-,2-,3- chamber as well as short axis acquisitions were made. In addition to conventional 2D, Doppler and TDI measurements, speckle tracking echocardiography was applied and LV global longitudinal strain was derived from the obtained images. Moreover, LV base and apex rotation angles were assessed from which LV twist was derived.
Results: The mean age of patients (17 men) was 41 ± 6.5 years old. Compared with controls, patients had similar conventional 2D and Doppler measurements. TDI revealed increased E/E’ in the patient group vs control group (8.72 ± 1.65 vs 4.6 ± 1.32, p<0.05). Strain analysis demonstrated reduced global longitudinal strain values in the patient vs control group (14.41 ± 3.2% vs 21.88 ± 2.18%, p<0.05). Furthermore, twist was increased in the patient group as compared to the healthy individuals (12.5 ± 2.6º vs 10.2 ± 1.8o, p<0.05). Additionally, longitudinal strain was found more affected in patients who were LGE-CMR positive than those with no enhancement (13.44±2.7 vs 15.19±1.4, p<0.05). This was more profound for the basal septal and posterolateral segments of the left ventricle as shown both by LGE-CMR and speckle tracking analysis.
Conclusions: Speckle tracking echocardiography revealed impaired strain and rotational indices, implying early myocardial involvement in patients with newly-diagnosed sarcoidosis. Those findings seem to be in excellent correlation with those of LGE-CMR. Therefore deformation imaging could be a valuable cost-effective and bedside adjunct for the screening of this patient group.
- © 2012 by American Heart Association, Inc.