PMID- 24829369
OWN - NLM
STAT- MEDLINE
DCOM- 20140902
LR  - 20151119
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 100
IP  - 15
DP  - 2014 Aug
TI  - Extensive late gadolinium enhancement on cardiovascular magnetic resonance 
      predicts adverse outcomes and lack of improvement in LV function after steroid 
      therapy in cardiac sarcoidosis.
PG  - 1165-72
LID - 10.1136/heartjnl-2013-305187 [doi]
AB  - BACKGROUND: Gadolinium-enhanced cardiovascular magnetic resonance is an emerging 
      tool for the diagnosis of cardiac sarcoidosis (CS); however, the correlations 
      between extent of late gadolinium enhancement (LGE) and efficacy of steroid 
      therapy and adverse outcomes in patients with CS remain unclear. OBJECTIVE: We 
      aimed to clarify the prognostic impact of extent of LGE in patients with CS. 
      METHODS: Before the start of steroid therapy, 43 consecutive LGE-positive 
      patients with CS were divided into two groups based on the extent of LGE by a 
      median value: small-extent LGE (LGE mass <20% of LV mass; n=21) and large-extent 
      LGE (LGE mass >/=20% of LV mass; n=22). We examined the correlations between extent 
      of LGE and outcomes after steroid therapy. RESULTS: Among the 6 patients who died 
      from heart disorders, 11 patients who were hospitalised because of heart failure 
      and 6 patients who suffered life-threatening arrhythmia during the follow-up 
      period, large-extent LGE predicted higher incidences of cardiac mortality and 
      hospitalisation for heart failure. Multivariate Cox regression analysis showed 
      that large-extent LGE was independently associated with combined adverse outcomes 
      including cardiac death, hospitalisation for heart failure, and life-threatening 
      arrhythmias. In the small-extent LGE group, LV end-diastolic volume index 
      significantly decreased and LVEF significantly increased after steroid therapy, 
      whereas in the large-extent LGE group, neither LV volume nor LVEF changed 
      substantially. CONCLUSIONS: Large-extent LGE correlates with absence of LV 
      functional improvement and high incidence of adverse outcomes in patients with CS 
      after steroid therapy.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Ise, Takayuki
AU  - Ise T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Hasegawa, Takuya
AU  - Hasegawa T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Morita, Yoshiaki
AU  - Morita Y
AD  - Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, 
      Japan.
FAU - Yamada, Naoaki
AU  - Yamada N
AD  - Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, 
      Japan.
FAU - Funada, Akira
AU  - Funada A
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Takahama, Hiroyuki
AU  - Takahama H
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Amaki, Makoto
AU  - Amaki M
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Kanzaki, Hideaki
AU  - Kanzaki H
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Okamura, Hideo
AU  - Okamura H
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Kamakura, Shiro
AU  - Kamakura S
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Shimizu, Wataru
AU  - Shimizu W
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Anzai, Toshihisa
AU  - Anzai T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
FAU - Kitakaze, Masafumi
AU  - Kitakaze M
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan Department of Clinical Research and Development, National 
      Cerebral and Cardiovascular Center, Osaka, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140514
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Contrast Media)
RN  - 0 (Glucocorticoids)
RN  - K2I13DR72L (Gadolinium DTPA)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Cardiomyopathies/*diagnosis/drug therapy/physiopathology
MH  - Contrast Media
MH  - Dose-Response Relationship, Drug
MH  - Echocardiography/methods
MH  - Follow-Up Studies
MH  - *Gadolinium DTPA
MH  - Glucocorticoids/administration & dosage
MH  - Heart Ventricles/drug effects/pathology/physiopathology
MH  - Image Enhancement/*methods
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Myocardium/pathology
MH  - Predictive Value of Tests
MH  - Prednisone/*administration & dosage
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Sarcoidosis/*diagnosis/drug therapy/physiopathology
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left/drug effects/*physiology
OTO - NOTNLM
OT  - Myocardial Disease
EDAT- 2014/05/16 06:00
MHDA- 2014/09/03 06:00
CRDT- 2014/05/16 06:00
PHST- 2014/05/16 06:00 [entrez]
PHST- 2014/05/16 06:00 [pubmed]
PHST- 2014/09/03 06:00 [medline]
AID - heartjnl-2013-305187 [pii]
AID - 10.1136/heartjnl-2013-305187 [doi]
PST - ppublish
SO  - Heart. 2014 Aug;100(15):1165-72. doi: 10.1136/heartjnl-2013-305187. Epub 2014 May 
      14.