Chest
Clinical InvestigationsSubclinical Cardiac Dysfunction in Sarcoidosis
Section snippets
Subject Selection
Thirty-eight sequential patients were referred to our Respiratory Division with a diagnosis of pulmonary sarcoidosis during the 18month period of the study. Three patients were excluded from the study because of the presence of one or more of the following exclusion criteria: presence of lung disease other than sarcoidosis, the presence of known intrinsic heart disease, systemic hypertension, anemia, diabetes mellitus, pregnancy, or medication use other than corticosteroids. Thirty-five
Subjects' Characteristics, Roentgenographic Stage, and Corticosteroid Treatment Status
The clinical characteristics of patients with sarcoidosis and normal controls are shown in Table 1. The range of time from diagnosis of sarcoidosis in the 35 patients was 1 to 240 months. Mean age and percentage of ideal body weight were significantly greater in the group with sarcoidosis compared with controls. Seventy-seven percent of the patients with sarcoidosis were symptomatic by questionnaire at the time of the study (Table 1). Symptoms included exertional dyspnea in 23, easy
Discussion
This study shows that patients with sarcoidosis frequently have symptomatic limitations to exercise accompanied by abnormal circulatory responses, suggesting that subclinical cardiac involvement in sarcoidosis is a common occurrence that is evident during exercise.
In sarcoidosis, exertional symptoms and limited exercise capacity are common, and they are often attributed solely to pulmonary involvement.17, 18, 19, 20 However, most of the patients in our study had normal results of PFTs with only
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Cited by (63)
Cardiac Sarcoidosis: A Review of Contemporary Challenges in Diagnosis and Treatment
2018, American Journal of the Medical SciencesCitation Excerpt :More than 50% of these patients complained of exertional dyspnea and had inappropriately high heart rate responses to exercise. These findings suggested that impaired cardiac rather than pulmonary function was the major limitation of exercise, indicating possible subclinical cardiac involvement in these patients.46 Twenty-four-hour Holter monitoring had been studied to identify arrhythmias and conduction disturbances in asymptomatic patients with CS.
Novel ECG parameters are strongly associated with inflammatory <sup>18</sup>F-FDG PET findings in patients with suspected cardiac sarcoidosis
2017, International Journal of CardiologyCitation Excerpt :Generally, the pathological findings related to CS in a stand-alone ECG are non-specific, but in conjunction with cardiac symptoms, findings such as bundle branch block (BBB), ventricular arrhythmias, II or III degree AV block, may contain clinically important information [3,16]. Conduction disturbances, arrhythmias and ST/T changes have been described as typical ECG findings in CS [2,17–19]. CS can affect virtually any location of the conduction system, leading to left or right BBB (complete or incomplete), AV block of any degree, and even sinus arrest.
Delayed enhancement on cardiac magnetic resonance imaging is a poor prognostic factor in patients with cardiac sarcoidosis
2012, Journal of CardiologyCitation Excerpt :Most of the CS patients in the present study were diagnosed in conjunction with involvement of other organs, again, a consistent finding with a previous study in Japan [15]. Almost half of CS patients in the present study showed no evidence of structural cardiac abnormality when assessed by echocardiography with a similar prevalence rate as in western studies with 14–31% prevalence rate [16,17], thus highlighting the limited sensitivity of echocardiography in this subset of CS patients [18]. In CS patients, the usual echocardiographic abnormality in our study was characteristic septal thinning, which was a part of LV being globally affected, and depressed LVEF characteristic of a DCM-like picture noted in half of them.
Rehabilitation and sarcoidosis
2012, Revue des Maladies Respiratoires ActualitesCardiac sarcoidosis
2012, Presse MedicaleCitation Excerpt :Usual ECG abnormalities must be taken into consideration. Sinusal tachycardia is frequent at rest or during exercise [29,111]. It is frequently associated to isotopic cardiac dysfunction [29].
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Recipient of an American Lung Association Research Training Fellowship.
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Sponsored by the Quebec Pulmonary Association.
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Supported by the Medical Research Council of Canada. Manuscript received May 10; revision accepted November 9.