title: Electrocardiographic abnormalities and risk of developing cardiac events in extracardiac sarcoidosis.
abstract: BACKGROUND
  Cardiac involvement is a leading cause of death from sarcoidosis. Because the efficacy of corticosteroid treatment is limited in patients with cardiac manifestation, early diagnosis is important. However, cardiac involvement is difficult to identify at early stages and is often underdiagnosed. Therefore, this study aimed to identify electrocardiographic risk factors for cardiac events in patients with extracardiac sarcoidosis.
  
  
  METHODS
  This prospective observational cohort study included 227 patients with extracardiac sarcoidosis who did not have any cardiac manifestation (age, 49 ± 17 years; women, 63%). We studied the association of electrocardiographic abnormalities with developing cardiac manifestations.
  
  
  RESULTS
  During a follow-up of 6.3 ± 3.7 years, 11 patients developed cardiac events, including advanced atrioventricular block (4 patients), ventricular tachycardia (4 patients), and systolic dysfunction (3 patients). All patients had electrocardiographic abnormalities prior to the development of cardiac events. In multivariate analyses, the baseline heart rate and PR interval were associated with increased risk of developing cardiac events. The QRS duration and corrected QT interval were not associated with cardiac manifestations. The multivariate analyses also revealed that baseline conduction disorder, ST segment/T wave abnormalities, and fragmented QRS complexes were associated with cardiac events.
  
  
  CONCLUSIONS
  Electrocardiographic abnormalities occurred prior to cardiac events in extracardiac sarcoidosis. Patients with electrocardiographic abnormalities may require further evaluation for cardiac involvement and careful follow-up.
authors.affiliation: Division of Cardiology, Niigata University Hospital, Niigata, Japan. Electronic address: peachberryapricotcandy@gmail.com.
authors.forename: Satomi
authors.initials: S
authors.lastname: Nagao
authors.affiliation: Division of Cardiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sobue
authors.affiliation: Division of Cardiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kodama
authors.affiliation: Division of Respiratory Medicine, Niigata University Hospital, Niigata, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Tanaka
authors.affiliation: Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Tanabe
authors.affiliation: Division of Respiratory Medicine, Niigata University Hospital, Niigata, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suzuki
authors.affiliation: Division of Respiratory Medicine, Niigata University Hospital, Niigata, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Watanabe
authors.affiliation: Division of Cardiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
authors.affiliation: Division of Cardiology, Niigata University Hospital, Niigata, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Minamino
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D054537:Atrioventricular Block / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D016001:Confidence Intervals; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012720:Severity of Illness Index; D015996:Survival Rate
keywords: Arrhythmia; Electrocardiography; Heart failure; Risk factors; Sarcoidosis