PMID- 31954639 OWN - NLM STAT- MEDLINE DCOM- 20210113 LR - 20220723 IS - 1876-7591 (Electronic) IS - 1936-878X (Print) IS - 1876-7591 (Linking) VI - 13 IP - 6 DP - 2020 Jun TI - Right Ventricular Abnormalities on Cardiovascular Magnetic Resonance Imaging in Patients With Sarcoidosis. PG - 1395-1405 LID - S1936-878X(19)31181-7 [pii] LID - 10.1016/j.jcmg.2019.12.011 [doi] AB - OBJECTIVES: This study aimed to determine the prevalence on cardiac magnetic resonance (CMR) of right ventricular (RV) systolic dysfunction and RV late gadolinium enhancement (LGE), their determinants, and their influences on long-term adverse outcomes in patients with sarcoidosis. BACKGROUND: In patients with sarcoidosis, RV abnormalities have been described on many imaging modalities. On CMR, RV abnormalities include RV systolic dysfunction quantified as an abnormal right ventricular ejection fraction (RVEF), and RV LGE. METHODS: Consecutive patients with biopsy-proven sarcoidosis who underwent CMR for suspected cardiac involvement were studied. They were followed for 2 endpoints: all-cause death, and a composite arrhythmic endpoint of sudden cardiac death or significant ventricular arrhythmia. RESULTS: Among 290 patients, RV systolic dysfunction (RVEF <40% in men and <45% in women) and RV LGE were present in 35 (12.1%) and 16 (5.5%), respectively. The median follow-up time was 3.2 years (interquartile range [IQR]: 1.6 to 5.7 years) for all-cause death and 3.0 years (IQR: 1.4 to 5.5 years) for the arrhythmic endpoint. On Cox proportional hazards regression multivariable analyses, only RVEF was independently associated with all-cause death (hazard ratio [HR]: 1.05 for every 1% decrease; 95% confidence interval [CI]: 1.01 to 1.09; p = 0.022) after adjustment for left ventricular EF, left ventricular LGE extent, and the presence of RV LGE. RVEF was not associated with the arrhythmic endpoint (HR: 1.01; 95% CI: 0.96 to 1.06; p = 0.67). Conversely, RV LGE was not associated with all-cause death (HR: 2.78; 95% CI: 0.36 to 21.66; p = 0.33), while it was independently associated with the arrhythmic endpoint (HR: 5.43; 95% CI: 1.25 to 23.47; p = 0.024). CONCLUSIONS: In this study of patients with sarcoidosis, RV systolic dysfunction and RV LGE had distinct prognostic associations; RV systolic dysfunction but not RV LGE was independently associated with all-cause death, whereas RV LGE but not RV systolic dysfunction was independently associated with sudden cardiac death or significant ventricular arrhythmia. These findings may indicate distinct implications for the management of RV abnormalities in sarcoidosis. CI - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Velangi, Pratik S AU - Velangi PS AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Chen, Ko-Hsuan Amy AU - Chen KA AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Kazmirczak, Felipe AU - Kazmirczak F AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Okasha, Osama AU - Okasha O AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - von Wald, Lisa AU - von Wald L AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Roukoz, Henri AU - Roukoz H AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Farzaneh-Far, Afshin AU - Farzaneh-Far A AD - Section of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois. FAU - Markowitz, Jeremy AU - Markowitz J AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Nijjar, Prabhjot S AU - Nijjar PS AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Bhargava, Maneesh AU - Bhargava M AD - Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Perlman, David AU - Perlman D AD - Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. FAU - Akcakaya, Mehmet AU - Akcakaya M AD - Department of Electrical and Computer Engineering, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota. FAU - Shenoy, Chetan AU - Shenoy C AD - Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. Electronic address: cshenoy@umn.edu. LA - eng GR - K23 HL132011/HL/NHLBI NIH HHS/United States GR - KL2 TR000113/TR/NCATS NIH HHS/United States GR - R00 HL111410/HL/NHLBI NIH HHS/United States GR - UL1 TR000114/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20200115 PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 SB - IM CIN - JACC Cardiovasc Imaging. 2020 Jun;13(6):1406-1408. PMID: 32307252 MH - Adult MH - Aged MH - Arrhythmias, Cardiac/etiology/mortality/physiopathology MH - Death, Sudden, Cardiac/etiology MH - Female MH - Heart Ventricles/*diagnostic imaging/physiopathology MH - Humans MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Prevalence MH - Prognosis MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Sarcoidosis/complications/*diagnostic imaging/mortality/physiopathology MH - *Stroke Volume MH - Systole MH - Time Factors MH - Ventricular Dysfunction, Right/*diagnostic imaging/etiology/mortality/physiopathology MH - *Ventricular Function, Right PMC - PMC9303493 MID - NIHMS1569501 OTO - NOTNLM OT - cardiovascular magnetic resonance OT - late gadolinium enhancement OT - outcomes OT - right ventricle OT - sarcoidosis OT - systolic dysfunction EDAT- 2020/01/20 06:00 MHDA- 2021/01/14 06:00 PMCR- 2022/07/21 CRDT- 2020/01/20 06:00 PHST- 2019/09/05 00:00 [received] PHST- 2019/12/04 00:00 [revised] PHST- 2019/12/09 00:00 [accepted] PHST- 2020/01/20 06:00 [pubmed] PHST- 2021/01/14 06:00 [medline] PHST- 2020/01/20 06:00 [entrez] PHST- 2022/07/21 00:00 [pmc-release] AID - S1936-878X(19)31181-7 [pii] AID - 10.1016/j.jcmg.2019.12.011 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2020 Jun;13(6):1395-1405. doi: 10.1016/j.jcmg.2019.12.011. Epub 2020 Jan 15.