PMID- 23498675
OWN - NLM
STAT- MEDLINE
DCOM- 20131017
LR  - 20220331
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 6
IP  - 4
DP  - 2013 Apr
TI  - CMR imaging predicts death and other adverse events in suspected cardiac 
      sarcoidosis.
PG  - 501-11
LID - S1936-878X(13)00133-2 [pii]
LID - 10.1016/j.jcmg.2012.10.021 [doi]
AB  - OBJECTIVES: This study aimed to demonstrate that the presence of late gadolinium 
      enhancement (LGE) is a predictor of death and other adverse events in patients 
      with suspected cardiac sarcoidosis. BACKGROUND: Cardiac sarcoidosis is the most 
      important cause of patient mortality in systemic sarcoidosis, yielding a 5-year 
      mortality rate between 25% and 66% despite immunosuppressive treatment. Other 
      groups have shown that LGE may hold promise in predicting future adverse events 
      in this patient group. METHODS: We included 155 consecutive patients with 
      systemic sarcoidosis who underwent cardiac magnetic resonance (CMR) for workup of 
      suspected cardiac sarcoid involvement. The median follow-up time was 2.6 years. 
      Primary endpoints were death, aborted sudden cardiac death, and appropriate 
      implantable cardioverter-defibrillator (ICD) discharge. Secondary endpoints were 
      ventricular tachycardia (VT) and nonsustained VT. RESULTS: LGE was present in 39 
      patients (25.5%). The presence of LGE yields a Cox hazard ratio (HR) of 31.6 for 
      death, aborted sudden cardiac death, or appropriate ICD discharge, and of 33.9 
      for any event. This is superior to functional or clinical parameters such as left 
      ventricular (LV) ejection fraction (EF), LV end-diastolic volume, or presentation 
      as heart failure, yielding HRs between 0.99 (per % increase LVEF) and 1.004 
      (presentation as heart failure), and between 0.94 and 1.2 for potentially lethal 
      or other adverse events, respectively. Except for 1 patient dying from pulmonary 
      infection, no patient without LGE died or experienced any event during follow-up, 
      even if the LV was enlarged and the LVEF severely impaired. CONCLUSIONS: Among 
      our population of sarcoid patients with nonspecific symptoms, the presence of 
      myocardial scar indicated by LGE was the best independent predictor of 
      potentially lethal events, as well as other adverse events, yielding a Cox HR of 
      31.6 and of 33.9, respectively. These data support the necessity for future 
      large, longitudinal follow-up studies to definitely establish LGE as an 
      independent predictor of cardiac death in sarcoidosis, as well as to evaluate the 
      incremental prognostic value of additional parameters.
CI  - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Greulich, Simon
AU  - Greulich S
AD  - Division of Cardiology, Robert-Bosch-Medical Center, Stuttgart, Germany.
FAU - Deluigi, Claudia Christina
AU  - Deluigi CC
FAU - Gloekler, Steffen
AU  - Gloekler S
FAU - Wahl, Andreas
AU  - Wahl A
FAU - Zurn, Christine
AU  - Zurn C
FAU - Kramer, Ulrich
AU  - Kramer U
FAU - Nothnagel, Detlev
AU  - Nothnagel D
FAU - Bultel, Helmut
AU  - Bultel H
FAU - Schumm, Julia
AU  - Schumm J
FAU - Grun, Stefan
AU  - Grun S
FAU - Ong, Peter
AU  - Ong P
FAU - Wagner, Anja
AU  - Wagner A
FAU - Schneider, Steffen
AU  - Schneider S
FAU - Nassenstein, Kai
AU  - Nassenstein K
FAU - Gawaz, Meinrad
AU  - Gawaz M
FAU - Sechtem, Udo
AU  - Sechtem U
FAU - Bruder, Oliver
AU  - Bruder O
FAU - Mahrholdt, Heiko
AU  - Mahrholdt H
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130314
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
RN  - 84F6U3J2R6 (gadodiamide)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adult
MH  - Cardiomyopathies/complications/*mortality/*pathology/physiopathology/therapy
MH  - Contrast Media
MH  - Death, Sudden, Cardiac/etiology/prevention & control
MH  - Defibrillators, Implantable
MH  - Electric Countershock/instrumentation
MH  - Female
MH  - Gadolinium DTPA
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - *Magnetic Resonance Imaging/methods
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardium/*pathology
MH  - Odds Ratio
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sarcoidosis/complications/*mortality/*pathology/physiopathology/therapy
MH  - Stroke Volume
MH  - Tachycardia, Ventricular/etiology/prevention & control
MH  - Time Factors
MH  - Ventricular Function, Left
EDAT- 2013/03/19 06:00
MHDA- 2013/10/18 06:00
CRDT- 2013/03/19 06:00
PHST- 2012/08/17 00:00 [received]
PHST- 2012/09/28 00:00 [revised]
PHST- 2012/10/11 00:00 [accepted]
PHST- 2013/03/19 06:00 [entrez]
PHST- 2013/03/19 06:00 [pubmed]
PHST- 2013/10/18 06:00 [medline]
AID - S1936-878X(13)00133-2 [pii]
AID - 10.1016/j.jcmg.2012.10.021 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2013 Apr;6(4):501-11. doi: 10.1016/j.jcmg.2012.10.021. 
      Epub 2013 Mar 14.