title: T wave amplitude in lead aVR as a novel diagnostic marker for cardiac sarcoidosis.
abstract: It is vital to identify cardiac involvement (CI) in patients with sarcoidosis as the condition could initially lead to sudden cardiac death. Although the T wave amplitude in lead aVR (TWAaVR) is reportedly associated with adverse cardiac events in various cardiovascular diseases, only scarce data are available concerning the utility of lead aVR in identifying CI in patients with sarcoidosis. We retrospectively investigated the diagnostic values of TWAaVR in patients with sarcoidosis in comparison with conventional electrocardiography parameters such as bundle branch block (BBB). From January 2006 to December 2014, 93 consecutive patients with sarcoidosis were enrolled (mean age, 55.7 ± 15.7 years; male, 31 %; cardiac involvement, n = 26). TWAaVR showed the greatest sensitivity (39 %) and specificity (92 %) in distinguishing between sarcoidosis patients with and without CI, at a cutoff value of -0.08 mV. The diagnostic value of BBB for cardiac involvement was significantly improved when combined with TWAaVR (sensitivity: 61-94 %, specificity: 97-89 %, area under the curve: 0.79-0.92, p = 0.018). Multivariate logistic regression analysis indicated that TWAaVR and BBB were independent electrocardiography parameters associated with CI. In summary, we observed that sarcoidosis patients exhibiting a high TWAaVR were likely to have CI. Thus, the application of a combination of BBB with TWAaVR may be useful when screening for CI in sarcoidosis patients.
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan. konnokontetsu@staff.kanazawa-u.ac.jp.|Research and Education Center for Innovative and Preventive Medicine, Kanazawa University, Kanazawa, 920-8640, Japan. konnokontetsu@staff.kanazawa-u.ac.jp.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Konno
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Toyonobu
authors.initials: T
authors.lastname: Tsuda
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furusho
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takamura
authors.affiliation: Innovative Clinical Research Center, Kanazawa University (iCREK), Kanazawa, 920-8641, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yoshimura
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis*; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D007564:Japan; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012507:Sarcoidosis / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity
keywords: Cardiac involvement; Electrocardiogram; Lead aVR; Sarcoidosis