[Spectrum of echocardiographic findings in patients with systemic sarcoidosis].
BACKGROUND
Sarcoidosis is a granulomatous disease that may involve multiple organ systems. Cardiac sarcoidosis may be a primary or a secondary process. Clinical manifestations of cardiac sarcoidosis include impulse conduction disorders, various arrhythmias, symptoms and signs of heart failure and even sudden death. The aim of the present paper was to assess the possibilities for echocardiographic detection of pathological changes in the hearts of patients with diagnosed systemic sarcoidosis.


METHODS
The study group consisted of 31 patients with histological evidence of sarcoidosis obtained by biopsy of target organ (most frequently the lungs). There were 26 females and 5 males, aged from 38 to 74 years, mean age 53.67 +/- 9.48 years. The duration of sarcoidosis varied from 1 to 33 years, mean duration 6.56 years. All patients underwent Color Doppler echocardiographic examination with standard echocardiographic views.


RESULTS
Increased left ventricular end-diastolic diameter was registered in 6/31 patients (19%), while end-systolic dimension was increased in 2 patients (6%). However, left ventricular dimensions were more increased in the group of patients with sarcoidosis lasting 4 years or longer. Majority of patients with sarcoidosis (27/31 or 86%) had normal values of left ventricular systolic function. The diastolic function of the left ventricle was impaired in 19/31 patients (61%). Only one female patient had hypertrophied apical segments of interventricular septum (15-17 mm) and lateral left ventricular wall (14 mm), while basal segments of inferior, posterior and lateral left ventricular walls were thin and dyskinetic, but coronary angiography revealed normal findings. Laminar fibrosis within interventricular septal myocardium was identified in 14/31 sarcoidosis patients (45%), while granulations in ventricular septal myocardium were present in 10/31 patients (32%). Right ventricular systolic pressure over 30 mmHg was established in 5/31 patients (16%). Slight pericardial effusion was found in 4/31 patients (12%).


CONCLUSIONS
Echocardiography is a very useful method for obtaining important information on morphological and functional changes in myocardium of patients with sarcoidosis. However, neither of previously mentioned echocardiographic signs is specific for cardiac sarcoidosis. The diagnosis of cardiac sarcoidosis cannot be made solely on the basis of echocardiographic findings. Other diagnostic procedures, from clinical findings to endomyocardial biopsy, must be employed as well.
Petrović
Milan
M
Klinicki Centar Srbije, Beograd. drmilanpet@ptt.yu
Vujisić-Tesić
Bosiljka
B
Boricić
Marija
M
D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left