BACKGROUND Sarcoidosis is a systemic granulomatous disease that may affect the myocardium. This study evaluated the diagnostic and prognostic value of 2-dimensional speckle tracking echocardiography in cardiac sarcoidosis (CS). METHODS Eighty-three patients with extracardiac, biopsy-proven sarcoidosis and definite/probable diagnosis of cardiac involvement diagnosed from January 2005 through December 2016 were included. Strain parameters in early stages of CS, in a subgroup of 23 CS patients with left ventricular ejection fraction (LVEF) within normal limits (LVEF> 52% for men: > 54% for women, mean value: 57.3% ± 3.8%) and no wall motion abnormalities was compared with 97 controls (1:4) without cardiac disease. LV and right ventricular (RV) global longitudinal (GLS), circumferential (GCS), and radial (GRS) strain and strain rate (SR) analyses were performed with TomTec software and correlated with cardiac outcomes (including heart failure and arrhythmias). This study was approved by the Mayo Clinic Institutional Review Board, and all patients gave informed written consent to participate. RESULTS Mean age of CS patients was 53.6 ± 10.8 years, and 34.9% were women. Mean LVEF was 43.2% ± 12.4%; LV GLS, - 12.4% ± 3.7%; LV GCS, - 17.1% ± 6.5%; LV GRS, 29.3% ± 12.8%; and RV wall GLS, 14.6% ± 6.3%. In the 23 patients with early stage CS with normal LVEF and RV systolic function, strain parameters were significantly reduced when compared with controls (respectively: LV GLS, - 15.9% ± 2.5% vs - 18.2% ± 2.7% [P = .001]; RV GLS, - 16.9% ± 4.5% vs - 24.1% ± 4.0% [P < .001]). A LV GLS value of - 16.3% provided 82.2% sensitivity and 81.2% specificity for the diagnosis of CS (AUC 0.91), while a RV value of - 19.9% provided 88.1% sensitivity and 86.7% specificity (AUC 0.93). Hospital admission and heart failure significantly correlated to impaired LV GLS (> - 14%). CONCLUSION Reduced strain values in the LV GLS and RV GLS can be used in the diagnostic algorithm in patients with suspicion of cardiac sarcoidosis. These values also correlate with adverse cardiovascular events.

中文翻译：

---

散斑跟踪超声心动图对心脏结节病的诊断和预测价值。

背景技术结节病是可能影响心肌的全身性肉芽肿性疾病。这项研究评估了二维散斑跟踪超声心动图在心脏结节病（CS）中的诊断和预后价值。方法纳入2005年1月至2016年12月诊断为心外膜，活检证实的结节病并明确/可能诊断为心脏受累的83例患者。在CS的早期阶段中，在23名CS患者的亚组中，其左心室射血分数（LVEF）在正常范围内（男性LVEF> 52％：女性> 54％，平均值：57.3％±3.8％），并且没有壁运动异常与没有心脏疾病的97个对照（1：4）进行了比较。左心室和右心室（RV）总纵（GLS），周向（GCS），使用TomTec软件进行径向（GRS）应变和应变率（SR）分析，并与心脏预后相关（包括心力衰竭和心律不齐）。这项研究得到了梅奥诊所机构审查委员会的批准，所有患者均签署了知情同意书。结果CS患者的平均年龄为53.6±10.8岁，女性为34.9％。平均LVEF为43.2％±12.4％; LV GLS--12.4％±3.7％；LV GCS，-17.1％±6.5％；LV GRS，29.3％±12.8％；和右室壁GLS为14.6％±6.3％。在23名具有CS LVEF和RV收缩功能正常的早期CS患者中，与对照组相比，应变参数显着降低（分别为：LV GLS--15.9％±2.5％vs-18.2％±2.7％[P = .001] ； RV GLS，-16.9％±4.5％和-24.1％±4.0％[P <.001]）。LV GLS值-16.3％提供82.2％的灵敏度和81。2％的CS诊断特异性（AUC 0.91），而RV值-19.9％提供88.1％的敏感性和86.7％的特异性（AUC 0.93）。入院和心力衰竭与LV GLS受损显着相关（>-14％）。结论LV GLS和RV GLS中降低的应变值可用于怀疑有心脏结节病的患者的诊断算法。这些值还与不良心血管事件相关。