title: Cardiac involvement in Caucasian patients with pulmonary sarcoidosis.
abstract: BACKGROUND
  Cardiac sarcoidosis (CS) is a potentially life-threatening condition. At present, there is no consensus with regard to the optimal non-invasive clinical evaluation and diagnostic procedures of cardiac involvement in patients with sarcoidosis. The aim of this study in a large homogenous Scandinavian sarcoidosis cohort was therefore to identify risk factors of cardiac involvement in patients with sarcoidosis, and the value of initial routine investigation with ECG and cardiac related symptoms in screening for CS.
  
  
  METHODS
  In this retrospective study a cohort of 1017 Caucasian patients with sarcoidosis were included. They were all screened with ECG at disease onset and investigated for CS according to clinical routine.
  
  
  RESULTS
  An abnormal ECG was recorded in 166 (16.3%) of the 1017 patients and CS was later diagnosed in 22 (13.2%) of them, compared to in one (0.1%) of the 851 sarcoidosis patients with a normal ECG (p < 0.0001). The risk for CS was higher in patients with a pathologic ECG combined with cardiac related symptoms (11/40) (27.5%) compared to those with pathologic ECG changes without symptoms (11/126) (8.7%) (p < 0.01). Furthermore, patients with Löfgren's syndrome had a reduced risk for CS compared to those without (p < 0.05) the syndrome.
  
  
  CONCLUSIONS
  This study on an unusually large and homogenous sarcoidosis population demonstrate the importance of an abnormal ECG and cardiac related symptoms at disease onset as powerful predictors of a later diagnosis of cardiac sarcoidosis. In contrast, CS is very rare in subjects without symptoms and with a normal ECG. This knowledge is of importance, and may be used in a clinical algorithm, in identifying patients that should be followed and investigated extensively for the presence of CS.
authors: Respiratory Medicine Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. pernilla.darlington@ki.se.
authors: Pernilla
authors: P
authors: Darlington
authors: Anders
authors: A
authors: Gabrielsen
authors: Peder
authors: P
authors: Sörensson
authors: Kerstin
authors: K
authors: Cederlund
authors: Anders
authors: A
authors: Eklund
authors: Johan
authors: J
authors: Grunewald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000208:ethnology*; D002648:Child; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000208:ethnology*; D044465:White People / Q000208:ethnology*; D055815:Young Adult