Diagnostic value of strain echocardiography, galectin-3, and tenascin-C levels for the identification of patients with pulmonary and cardiac sarcoidosis.
BACKGROUND
Cardiac involvement in sarcoidosis has been associated with poor prognosis. We evaluated myocardial contractility quantitatively in a cohort of pulmonary sarcoidosis (PS) patients with and without cardiac involvement. We also studied markers of fibrosis (tenascin-C [Tn-C] and galectin-3 [Gl-3]) as diagnostic tools for PS and cardiac sarcoidosis (CS).


METHODS
Forty ambulatory patients with PS of grades 1-2 and 26 healthy subjects were prospectively enrolled. All patients with PS underwent cardiac magnetic resonance (CMR) to explore the presence of CS. The study population was divided into three groups: controls (n = 26), non-CS patients (n = 34), and CS patients (n = 6). Speckle-tracking strain echocardiography (STE) was performed on all patients, and Gl-3 and Tn-C values were measured in all patients and controls.


RESULTS
PS patients had higher levels of Gl-3 and Tn-C than did controls, and the STE parameters of PS patients, including global longitudinal strain (GLS) and global circumferential strain (GCS), were lower than those of controls (p < 0.001 for all comparisons). GLS values were lower in CS patients than in the other groups (p = 0.05).


CONCLUSIONS
PS patients demonstrate reduced cardiac contractility, independent of CMR-proven structural cardiac lesions, while patients with structural lesions have a more pronounced drop in strain parameters. Tn-C and Gl-3 are promising markers for the diagnosis of PS, but they are not specific for cardiac involvement.
Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan cad.), Fatih, 34093, Istanbul, Turkey, doktorseref@hotmail.com.
Seref
S
Kul
Hatice Kutbay
HK
Ozcelik
Huseyin
H
Uyarel
Gultekin
G
Karakus
Tolga Sinan
TS
Guvenc
Murat
M
Yalcınsoy
Emin
E
Asoglu
Ahu Sarbay
AS
Kemik
Abdurrahman
A
Tasal
Sinem
S
Gungor
Ercan
E
Karaarslan
Levent
L
Kart
Omer
O
Goktekin
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D009202:Cardiomyopathies / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D005260:Female; D005355:Fibrosis; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012507:Sarcoidosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017565:Sarcoidosis, Pulmonary / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D019063:Tenascin / Q000097:blood*
D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human; D019063:Tenascin