Abstract 16202: Speckle Tracking Echocardiography for Early Screening for Subclinical Cardiac Sarcoidosis, a Meta-analysis

Abstract

Background: Cardiac sarcoidosis (CS) affects 35% of patients with pulmonary sarcoidosis (PS). CS presentation varies from asymptomatic patients to sudden cardiac death. The current screening modalities like EKG and conventional echocardiography lack sensitivity for early detection of CS. Speckle tracking echocardiography (STE) has shown potential for early detection of subclinical myocardial damage in patients with PS. We aimed to investigate the role of STE in early detection of CS. Methods: We queried Medline, EmCare, CINAHL, Cochrane Database and Google Scholar for articles investigating the role of left ventricle global longitudinal strain (LVGLS) in asymptomatic patients with PS versus (vs) controls. Studies that included patients with suspected or proven CS, patients with cardiac symptoms, arrhythmias, coronary artery disease or valvular abnormalities were excluded. The standard mean difference (SMD) in GLS for both groups was pooled using random effects model. Results: Our search yielded a total of 9 studies with a total of 967 patients with PS undergoing screening for CS. In individual studies, the baseline characteristics were not significantly different between both groups. Overall, the studies had more females than males. All patients in our cohort had preserved ejection fraction (EF) and no cardiac symptoms. The LVGLS was significantly decreased in the PS group as compared to controls, SMD: -3.98, (95% CI: -5.32 to -2.64; p-value <0.0001), I 2 = 94.70%, Figure 1. Conclusion: As compared to controls, patients with PS with no clinically suspected or proven CS, and normal EF, have impaired LVGLS. More studies are warranted to investigate the role of LVGLS in CS screening.