PMID- 28967698 OWN - NLM STAT- MEDLINE DCOM- 20181025 LR - 20220409 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 5 IP - 1 DP - 2018 Feb TI - Right ventricular involvement and the extent of left ventricular enhancement with magnetic resonance predict adverse outcome in pulmonary sarcoidosis. PG - 157-171 LID - 10.1002/ehf2.12201 [doi] AB - AIMS: Cardiac involvement is the main determinant of poor outcomes in sarcoidosis. Right ventricular (RV) dysfunction and left ventricular (LV) late gadolinium enhancement (LGE) have been reported to be predictive of adverse outcome in non-ischaemic cardiomyopathies. The aim of our study was to determine whether delayed RV LGE with cardiovascular magnetic resonance would be predictive of adverse events in addition to LV LGE during the long-term follow-up of pulmonary sarcoidosis patients. METHODS AND RESULTS: Eighty-four consecutive biopsy-proven pulmonary sarcoidosis patients were followed for a median of 56 months [38-74] after baseline delayed contrast-enhanced cardiac magnetic resonance. The composite primary endpoint consisted of admission for congestive heart failure, sustained ventricular tachycardia, appropriate implantable cardioverter defibrillator therapy, pacemaker implantation for high degree atrio-ventricular block, or cardiac death. The composite secondary endpoint included all-cause mortality in addition to the primary endpoint. RV and LV LGE were demonstrated in respectively 12 and 27 patients. Five of 10 events included in the primary endpoint occurred in the group with RV LGE. RV LGE, LV, or biventricular LGE yielded Cox hazard ratios of 8.71 [95% confidence interval (CI) 1.90-23.81], 9.22 (95% CI 1.96-43.45), and 12.09 (95% CI 3.43-42.68) for the composite primary endpoint. In a multivariate model, the predictive value of biventricular LGE for the composite primary and secondary endpoints was strongest. Kaplan-Meier event-free survival curves were most significant for RV LGE and biventricular LGE (log rank with P < 0.001). CONCLUSIONS: Biventricular LGE at presentation is the strongest, independent predictor of adverse outcome during long-term follow-up. Asymptomatic myocardial scar <8% of LV mass carried a favourable long-term outcome. CI - (c) 2017 The Authors ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. FAU - Smedema, Jan-Peter AU - Smedema JP AD - Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands. FAU - van Geuns, Robert-Jan AU - van Geuns RJ AD - Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands. FAU - Ector, Joris AU - Ector J AD - Department of Cardiology, University Hospitals Gasthuisberg, Leuven, Belgium. FAU - Heidbuchel, Hein AU - Heidbuchel H AD - Virga Jesse Hospital, University of Hasselt Heart Centre, Hasselt, Belgium. FAU - Ainslie, Gillian AU - Ainslie G AD - Respiratory Clinic, Department of Medicine, Groote Schuur Hospital, Cape Town, Republic of South Africa. FAU - Crijns, Harry J G M AU - Crijns HJGM AD - Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands. LA - eng PT - Journal Article DEP - 20171002 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 SB - IM MH - Cardiomyopathies/complications/epidemiology/*pathology MH - Female MH - Follow-Up Studies MH - Heart Ventricles/*pathology/physiopathology MH - Humans MH - Incidence MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Middle Aged MH - Myocardium/*pathology MH - Netherlands/epidemiology MH - Prospective Studies MH - *Risk Assessment MH - Risk Factors MH - Sarcoidosis, Pulmonary/*complications/diagnosis MH - Ventricular Dysfunction, Right/diagnosis/*etiology/physiopathology PMC - PMC5793959 OTO - NOTNLM OT - Cardiovascular magnetic resonance OT - Late gadolinium enhancement OT - Right ventricle OT - Risk stratification OT - Sarcoidosis COIS- None declared. EDAT- 2017/10/03 06:00 MHDA- 2018/10/26 06:00 PMCR- 2017/10/02 CRDT- 2017/10/03 06:00 PHST- 2017/05/17 00:00 [received] PHST- 2017/07/14 00:00 [accepted] PHST- 2017/10/03 06:00 [pubmed] PHST- 2018/10/26 06:00 [medline] PHST- 2017/10/03 06:00 [entrez] PHST- 2017/10/02 00:00 [pmc-release] AID - EHF212201 [pii] AID - 10.1002/ehf2.12201 [doi] PST - ppublish SO - ESC Heart Fail. 2018 Feb;5(1):157-171. doi: 10.1002/ehf2.12201. Epub 2017 Oct 2.