title: The usefulness of left atrial volume index and left ventricular mass index in determining subclinical cardiac involvement in patients with early-stage sarcoidosis.
abstract: OBJECTIVE
  Sarcoidosis is a multi-systemic granulomatous disease of unknown etiology. The present study has been designed to evaluate the importance of diastolic dysfunction with left atrial volume index (LAVi) and left ventricular mass index (LVMi) in determining subclinical cardiac involvement in subjects with stage I-II pulmonary sarcoidosis.
  
  
  METHODS
  A total of 54 patients under follow-up for sarcoidosis without cardiac involvement and 56 healthy subjects were included in the study. The echocardiographic assessment of the patients revealed no significant difference between the two groups regarding left ventricular end-systolic and end-diastolic diameters, ejection fraction (LVEF) and annular velocity determined by tissue Doppler evaluation.
  
  
  RESULTS
  The LVEF calculated was 61.8 ± 7.8 % in the sarcoidosis group versus 64.1 ± 2.7 % in the control group (p = 0.04). Left ventricular interventricular septum thickness, posterior wall thickness, and relative wall thickness were significantly higher in the sarcoidosis group compared to the control group (p < 0.001). The sarcoidosis group had higher LVM and LVMi values compared to the control group (145 ± 18.1 and 79 ± 14 g/m(2), 135 ± 27.7 and 74 ± 14.2 g/m(2); p = 0.020 and p = 0.021, respectively). Left atrial end-systolic volume and LAVi were higher in the sarcoidosis group (28.7 ± 18.5; 15.6 ± 10.2) compared to the control group (16.6 ± 10.9; 8.9 ± 5.5) with a statistically significant difference (p < 0.001).
  
  
  CONCLUSIONS
  The present study indicates diastolic dysfunction and increased LVMi despite normal systolic function in patients with early-stage sarcoidosis without cardiac involvement. Also, the diastolic parameters were normal without showing any significant difference compared to the control group while there was a statistically significant increase in LAVi. This finding suggests that LAVi may be the earliest marker of diastolic dysfunction in patients with early-stage sarcoidosis without cardiac involvement.
authors.affiliation: Faculty of Medicine, Department of Cardiology, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: H A
authors.initials: HA
authors.lastname: Kasapkara
authors.affiliation: Department of Pulmonary Diseases, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Şentürk
authors.affiliation: Department of Cardiology, Ankara Ataturk Education and Research Hospital, Bilkent, 06800, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Bilen
authors.affiliation: Department of Cardiology, Ankara Ataturk Education and Research Hospital, Bilkent, 06800, Ankara, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Duran Karaduman
authors.affiliation: Faculty of Medicine, Department of Cardiology, Yıldırım Beyazıt University, Ankara, Turkey. huseyinayhan44@yahoo.com.|Department of Cardiology, Ankara Ataturk Education and Research Hospital, Bilkent, 06800, Ankara, Turkey. huseyinayhan44@yahoo.com.
authors.forename: H
authors.initials: H
authors.lastname: Ayhan
authors.affiliation: Department of Cardiology, Ankara Ataturk Education and Research Hospital, Bilkent, 06800, Ankara, Turkey.
authors.forename: M B
authors.initials: MB
authors.lastname: Özen
authors.affiliation: Faculty of Medicine, Department of Cardiology, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Durmaz
authors.affiliation: Faculty of Medicine, Department of Cardiology, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Keleş
authors.affiliation: Faculty of Medicine, Department of Cardiology, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Bozkurt
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012507:Sarcoidosis / Q000150:complications* / Q000000981:diagnostic imaging; D018487:Ventricular Dysfunction, Left / Q000209:etiology*
keywords: Early grade sarcoidosis; Left atrial volume index; Left ventricular mass index