title: Prognostic Value of Myocardial Scarring on CMR in Patients With Cardiac Sarcoidosis.
abstract: This study sought to perform a systematic review and meta-analysis to understand the prognostic value of myocardial scarring as evidenced by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging in patients with known or suspected cardiac sarcoidosis.
  
  
  
  Although CMR is increasingly used for the diagnosis of cardiac sarcoidosis, the prognostic value of CMR has been less well described in this population.
  
  
  
  PubMed, Cochrane CENTRAL, and metaRegister of Controlled Trials were searched for CMR studies with ≥1 year of prognostic data. Primary endpoints were all-cause mortality and a composite outcome of arrhythmogenic events (ventricular arrhythmia, implantable cardioverter-defibrillator shock, sudden cardiac death) plus all-cause mortality during follow-up. Summary effect estimates were generated with random-effects modeling.
  
  
  
  Ten studies were included, involving a total of 760 patients with a mean follow-up of 3.0 ± 1.1 years. Patients had a mean age of 53 years, 41% were male, 95.3% had known extracardiac sarcoidosis, and 21.6% had known cardiac sarcoidosis. The average ejection fraction was 57.8 ± 9.1%. Patients with LGE had higher odds for all-cause mortality (odds ratio [OR]: 3.06; p < 0.03) and higher odds of the composite outcome (OR: 10.74; p < 0.00001) than those without LGE. Patients with LGE had an increased annualized event rate of the composite outcome (11.9% vs. 1.1%; p < 0.0001).
  
  
  
  In patients with known or suspected cardiac sarcoidosis, the presence of LGE on CMR imaging is associated with increased odds of both all-cause mortality and arrhythmogenic events.
authors.affiliation: Department of Medicine, University of Virginia, Charlottesville, Virginia.
authors.forename: G Cameron
authors.initials: GC
authors.lastname: Coleman
authors.affiliation: Department of Medicine, University of Virginia, Charlottesville, Virginia.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Shaw
authors.affiliation: Department of Medicine, University of Virginia, Charlottesville, Virginia.
authors.forename: Pelbreton C
authors.initials: PC
authors.lastname: Balfour
authors.affiliation: Department of Medicine, University of Virginia, Charlottesville, Virginia.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Gonzalez
authors.affiliation: Department of Medicine, University of Virginia, Charlottesville, Virginia; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Kramer
authors.affiliation: Department of Medicine, University of Chicago Medicine, Chicago, Illinois; Department of Radiology, University of Chicago Medicine, Chicago, Illinois.
authors.forename: Amit R
authors.initials: AR
authors.lastname: Patel
authors.affiliation: Department of Medicine, University of Virginia, Charlottesville, Virginia; Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia. Electronic address: ms5pc@virginia.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Salerno
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D013997:Time Factors
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: cardiac magnetic resonance; cardiac sarcoid; cardiovascular outcomes; late gadolinium enhancement