Electrophysiology study for risk stratification in patients with cardiac sarcoidosis and abnormal cardiac imaging.

Autor:	Okada DR; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Smith J; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Derakhshan A; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Gowani Z; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Zimmerman SL; Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, United States of America., Misra S; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Berger RD; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Calkins H; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Tandri H; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America., Chrispin J; Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States of America.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2019 Mar 16; Vol. 23, pp. 100342. Date of Electronic Publication: 2019 Mar 16 (Print Publication: 2019).
DOI:	10.1016/j.ijcha.2019.03.002
Abstrakt:	Background: Abnormalities on cardiac imaging (cardiac magnetic resonance imaging [CMR] or positron emission tomography [PET]), left ventricular ejection fraction (LVEF), and electrophysiology study (EPS) all predict ventricular arrhythmias (VA) in patients with cardiac sarcoidosis (CS). We sought to assess the utility of EPS in patients with CS and abnormal cardiac imaging, focusing on those with LVEF >35%. Methods: We identified all patients treated at our institution from 2000 to 2017 who: 1.) had probable or definite CS; 2.) had either late gadolinium enhancement (LGE) on CMR or abnormal 18-flourodeoxyglucose (FDG) uptake on PET, and 3.) had undergone EPS. The primary endpoint was VA during follow up. Results: Twenty five patients were included, of whom 10 (40%) had positive EPS. During a mean follow-up of 4.8 +/- 3.4 years, 11 (44%) patients had VA. The positive predictive value (PPV) of EPS for VA was 100% and the negative predictive value (NPV) of EPS for VA was 93%. Among 12 patients with LVEF >35% and no prior VA, the PPV of EPS for VA was 100% and the NPV of EPS for VA was 90%. Conclusion: EPS may help with risk stratification in patients with CS and abnormal imaging, especially those without conventional indications for ICD placement. Among patients with LVEF >35% and no history of prior VA, a negative EPS has good positive and negative predictive value for future VA events.
Databáze:	MEDLINE
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