Prognostic Value of Late Gadolinium Enhancement Detected on Cardiac Magnetic Resonance in Cardiac Sarcoidosis.

Autor:	Stevenson A; Department of Cardiology, Royal Free Hospital, London, United Kingdom. Electronic address: alexander.stevenson1@nhs.net., Bray JJH; Institute of Life Science, Swansea Bay University Health Board and Swansea University Medical School, Swansea, United Kingdom., Tregidgo L; Department of Cardiology, Royal Free Hospital, London, United Kingdom., Ahmad M; Tahir Heart Institute, Rabwah, Pakistan., Sharma A; University College London Medical School, University College London, London, United Kingdom., Ng A; University College London Medical School, University College London, London, United Kingdom., Siddiqui A; University College London Medical School, University College London, London, United Kingdom., Khalid AA; Guys and St Thomas' National Health Service Foundation Trust, London, United Kingdom., Hylton K; University College London Medical School, University College London, London, United Kingdom., Ionescu A; Institute of Life Science, Swansea Bay University Health Board and Swansea University Medical School, Swansea, United Kingdom., Providencia R; Institute of Health Informatics Research, St Bartholomew's Hospital, Barts Heart Centre, Barts Health National Health Service Trust, West Smithfield, London, United Kingdom., Kirresh A; University Hospitals Sussex, Royal Sussex County Hospital, Brighton, United Kingdom.
Jazyk:	angličtina
Zdroj:	JACC. Cardiovascular imaging [JACC Cardiovasc Imaging] 2023 Mar; Vol. 16 (3), pp. 345-357. Date of Electronic Publication: 2023 Jan 11.
DOI:	10.1016/j.jcmg.2022.10.018
Abstrakt:	Background: Sarcoidosis is a complex multisystem inflammatory disorder, with approximately 5% of patients having overt cardiac involvement. Patients with cardiac sarcoidosis are at an increased risk of both ventricular arrhythmias and sudden cardiac death. Previous studies have shown that the presence of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is associated with an increased risk of mortality and ventricular arrhythmias and may be useful in predicting prognosis. Objectives: This systematic review and meta-analysis assessed the value of LGE on CMR imaging in predicting prognosis for patients with known or suspected cardiac sarcoidosis. Methods: The authors searched the Embase and MEDLINE databases from inception to March 2022 for studies reporting individuals with known or suspected cardiac sarcoidosis referred for CMR with LGE. Outcomes were defined as all-cause mortality, ventricular arrhythmia, or a composite outcome of either death or ventricular arrhythmias. The primary analysis evaluated these outcomes according to the presence of LGE. A secondary analysis evaluated outcomes specifically according to the presence of biventricular LGE. Results: Thirteen studies were included (1,318 participants) in the analysis, with an average participant age of 52.0 years and LGE prevalence of 13% to 70% over a follow-up of 3.1 years. Patients with LGE on CMR vs those without had higher odds of ventricular arrhythmias (odds ratio [OR]: 20.3; 95% CI: 8.1-51.0), all-cause mortality (OR: 3.45; 95% CI: 1.6-7.3), and the composite of both (OR: 9.2; 95% CI: 5.1-16.7). Right ventricular LGE is invariably accompanied by left ventricular LGE. Biventricular LGE is also associated with markedly increased odds of ventricular arrhythmias (OR: 43.6; 95% CI: 16.2-117.2). Conclusions: Patients with known or suspected cardiac sarcoidosis with LGE on CMR have significantly increased odds of both ventricular arrhythmias and all-cause mortality. The presence of biventricular LGE may confer additional prognostic information regarding arrhythmogenic risk. Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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