title: Cardiovascular magnetic resonance-guided diagnosis of cardiac affection in a Caucasian sarcoidosis population.
abstract: BACKGROUND
  Clinically evidenced cardiac involvement in systemic sarcoidosis occurs in approximately 5% of patients, whereas post-mortem examinations identify cardiac sarcoidosis in over 60% of cases.
  
  
  OBJECTIVE
  Given the inconsistency of diagnostic approaches, we took aim at prospectively investigating the prevalence of cardiac sarcoidosis by cardiovascular magnetic resonance (CMR) in a primary Caucasian population and at correlating the results with standard clinical parameters.
  
  
  METHODS
  188 patients with histologically proven sarcoidosis were included, provenient from the local pneumological department and a national sarcoidosis self-help association. All of them underwent CMR-imaging. Complementary 12-lead ECG, Holter monitoring, laboratory and pulmonary function testing were performed.
  
  
  RESULTS
  CMR-based diagnosis of cardiac sarcoidosis was made in 29 patients (15.4%), of whom 17 patients (9% of total cohort) exhibited increased relative gadolinium enhancement - reflecting acute inflammatory processes -, while 11 patients (5.9% of total cohort) showed late gadolinium enhancement as a marker for nonviable tissue damage. Both abnormalities were present in 1 patient (0.5%). Correlation analysis evinced significant association between CMR-diagnosed cardiac sarcoidosis and reduction in LVEF, increase in diastolic interventricular septal thickness, diastolic dysfunction as well as limited electrocardiographic abnormalities. Neither laboratory values nor pulmonary function parameters correlated with presence or activity of cardiac sarcoidosis.
  
  
  CONCLUSIONS
  Among our predominantly Caucasian sarcoidosis study population, CMR-detected cardiac affection occurred in 15.4% and was missed by internationally valid standard clinical testing in all but one case. It reinforces CMR's diagnostic value as modality of choice to evaluate cardiac sarcoidosis. The estimation of its prognostic potential and its value in assessing the incidence of cardiac sarcoidosis however requires further longitudinal investigation.
authors: University Hospital Bonn, Department of Internal Medicine II, Cardiology, Pneumology and Angiology, Bonn, Germany. carmen.pizarro@arcor.de.
authors: Carmen
authors: C
authors: Pizarro
authors: Andreas
authors: A
authors: Goebel
authors: Darius
authors: D
authors: Dabir
authors: Christoph
authors: C
authors: Hammerstingl
authors: Stefan
authors: S
authors: Pabst
authors: Christian
authors: C
authors: Grohé
authors: Rolf
authors: R
authors: Fimmers
authors: Birgit
authors: B
authors: Stoffel-Wagner
authors: Georg
authors: G
authors: Nickenig
authors: Hans
authors: H
authors: Schild
authors: Dirk
authors: D
authors: Skowasch
authors: Daniel
authors: D
authors: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000208:ethnology / Q000209:etiology / Q000473:pathology*; D003287:Contrast Media; D003951:Diagnostic Errors; D015716:Electrocardiography, Ambulatory; D005260:Female; D019786:Gadolinium DTPA; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D044465:White People
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA