title: Capability of three-dimensional speckle tracking radial strain for identification of patients with cardiac sarcoidosis.
abstract: Since cardiac sarcoidosis (CS) leads to substantial morbidity and sudden death, early diagnosis and appropriate management are crucial for patients with CS. Echocardiography used to be considered a useful diagnostic tool for patients with CS, but CS may clinically present as dilated cardiomyopathy (DCM). Our objective was to investigate whether a novel three-dimensional (3-D) speckle-tracking strain can identify patients with CS more accurately. We studied 23 CS patients with an ejection fraction (EF) of 46 ± 10 %, and 16 EF-matched patients with DCM (EF 45 ± 11 %). Global radial (GRS), circumferential (GCS) and longitudinal (GLS) strain was assessed using 3-D speckle-tracking system. GRS of patients with CS was significantly lower than that of patients with DCM (18.5 ± 8.4 vs. 28.5 ± 8.3 %, p < 0.01), but GCS and GLS in patients with CS and DCM were similar. GRS ≦ 21.1 could differentiate CS from DCM with a sensitivity of 70 %, specificity of 88 % and area under the curve of 0.79. An additional noteworthy findings was that, patients with CS showed more negative radial strain curves than did those with DCM (1.7 ± 2.3 vs. 0.1 ± 0.5, p < 0.01). In conclusion, 3-D speckle-tracking radial strain shows good potential to distinguish CS from DCM. Our observations can thus be expected to have clinical implications for management of CS patients.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tsuji
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kensuke
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyoshi
authors.forename: Mana
authors.initials: M
authors.lastname: Hiraishi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kaneko
authors.forename: Keiko
authors.initials: K
authors.lastname: Ryo
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tatsumi
authors.forename: Tetsuari
authors.initials: T
authors.lastname: Onishi
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kawai
authors.forename: Ken-ich
authors.initials: KI
authors.lastname: Hirata
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D018619:Echocardiography, Doppler, Pulsed; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013318:Stroke Volume; D016277:Ventricular Function, Left