High mass (> 18 g) of late gadolinium enhancement on CMR imaging is associated with major cardiac events on long-term outcome in patients with biopsy-proven extracardiac sarcoidosis

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• 作者：Lucia Agoston-Coldea^a ; Sylvain Kouaho^a ; Karim Sacre^b ; Antoine Dossier^b ; Brigitte Escoubet^c ; Sylvie Chillon^a ; Jean-Pierre Laissy^a ; Franç ; ois Rouzet^d ; Shelby Kutty^a ; Fabrice Extramiana^e ; Antoine Leenhardt^e ; Raphael Borie^f ; Bruno Crestani^f ; Phalla Ou^a ; ^g ; ^{phalla.ou@aphp.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cardiac sarcoidosis ; Cardiac magnetic resonance imaging ; Late gadolinium enhancement
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 November 2016
• 年：2016
• 卷：222
• 期：Complete
• 页码：950-956
• 全文大小：525 K

文摘

Cardiac involvement is the most important cause of mortality in patients with systemic sarcoidosis. Late gadolinium enhancement (LGE) on cardiovascular magnetic resonance imaging (CMR) has been shown to be a predictor of major cardiovascular adverse events (MACE) in the setting of systemic sarcoidosis. We sought to evaluate the relationship between LGE mass and adverse long-term outcome in patients with biopsy-proven extracardiac sarcoidosis.

Methods

Between 2001 and 2013, 197 consecutive patients with suspected cardiac sarcoidosis were identified in our institution database. Of them, 56 patients have had biopsy-proven extracardiac sarcoidosis and represented our studied population. Patients were divided into two groups based on LGE mass by a median value (mild LGE < 18 g, high LGE > 18 g) for comparison of MACE.

Results

Twenty-eight patients had a high mass of LGE. Of them, 15 (54%) experienced MACE (OR = 31.15, 95% CI 3.7–262). Except for 1 patient, no patient with mild LGE presented with any MACE during follow-up (median of 32 months). Patients with high LGE had lower CMR-derived left (53.6 ± 14.9 vs. 62.2 ± 6.7, p < 0.01) and right (49.1 ± 11.5 vs. 56.4 ± 9.2, p < 0.05) ventricular ejection fractions. LGE mass of 18 g discriminated patients with and without MACE (93% sensitivity, 88% specificity, AUC = 0.972). LGE mass was the only independent predictor of MACE on multivariate Cox analysis adjusted (OR = 1.7, 95% CI 1.06 to 2.72, p = 0.03).

Conclusion

In biopsy-proven extracardiac sarcoidosis patients, a high mass of LGE > 18 g was associated with MACE.