Cardiac sarcoidosis detected by magnetic resonance imaging – Preliminary report of prospective study

Abstract

Background: Sarcoidosis is a systemic granulomatous disease which predominantly affects the lungs, although granulomas can also involve all other organs, including the heart. Cardiac sarcoidosis (CS) may occur at any stage of the disease and may be the cause of sudden cardiac death, even in a previously asymptomatic patient, therefore early detection is advised. The aim of this study was to evaluate the incidence of cardiac sarcoidosis in patients diagnosed or followed up due to sarcoidosis. Methods: We performed a prospective study in consecutive patients diagnosed or followed up due to sarcoidosis starting from September 2012 and ending December 2014. Only those with biopsy confirmed diagnosis of sarcoidosis were included. Magnetic resonance imaging was performed in all of them to confirm/exclude cardiac involvement. Results: 176 sarcoidosis patients (58.5% men) were included during 28 months and 41(23.3%) of them were diagnosed as stage I, 132(75.0%) as stage II and 3(1.7%) as stage III of the disease. Cardiac involvement in MRI was found in 40 patients (22.7%), 75% of whom were men. The odds ratio for having cardiac involvement in men compared to women was 2.59 (95%CI: 1.17 to 5.71, p=0.0184). Symptoms suggesting CS were present in 60% of diagnosed (OR: 3.48; 95%CI: 1.67 to 7.22, p=0.0008). Extrathoracic sarcoidosis also was a risk factor for CS (OR: 3.28; 95%CI: 1.58 to 6.83, p=0.0015). Conclusions: Cardiac involvement (active lesions in MRI) was diagnosed in 23% screened patients. Male sex, heart related symptoms and multiorgan involvement seems to be risk factors for cardiac sarcoidosis.