Prognostic significance of ventricular late potentials in patients with pulmonary sarcoidosis

Early detection of cardiac involvement in sarcoidosis is difficult but essential to achieve optimal treatment. Signal-averaged electrocardiography (SAECG) can detect subtle cardiac electrical abnormalities termed late potentials (LPs) and would be useful for the early diagnosis of cardiac involvement.
Source: Heart Rhythm - Category: Cardiology Authors: Tags: Featured Article Source Type: research

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This article focuses on the role of echocardiography and MRI in the diagnosis of these structural diseases. Cardiomyopathies with hypertrophic pattern (hypertrophic cardiomyopathy, restrictive cardiomyopathies, amyloidosis, Anderson-Fabry disease, and sarcoidosis), cardiomyopathies with dilated pattern, inflammatory cardiac diseases, and right ventricular arrhythmogenic cardiomyopathy are analyzed. Finally, anatomic predictors of arrhythmias and sudden cardiac death are discussed. Each paragraph is attended by clinical cases that are discussed on the electrocardiogram, after integrated with the anatomic, functional, and he...
Source: Cardiac Electrophysiology Clinics - Category: Cardiology Source Type: research
Predominant or isolated right ventricular involvement in cardiac sarcoidosis is uncommon, but should always be considered in a case of right ventricular hypertrophy combined with ventricular arrhythmia and/or conduction disturbance. Although improvement in right ventricular hypertrophy and atrioventricular conduction disturbance following corticosteroid therapy has been reported, the detailed serial electrocardiographic responses during corticosteroid therapy, as well as temporal changes in the electrocardiographic, biochemical, and morphological responses, have not been reported.
Source: Journal of Electrocardiology - Category: Cardiology Authors: Source Type: research
Abstract A 52‐year‐old male visited our hospital with abnormal electrocardiogram and exertional fatigue. The electrocardiogram showed first‐degree atrioventricular block, complete right bundle branch block, and inverted T waves in Leads II, III, aVF, V3, and V4. Echocardiography showed biventricular wall thickening involving granular sparkling of the interventricular septum. Late gadolinium enhancement on cardiovascular magnetic resonance (CMR) was found at the circumferential right ventricular wall and patchy regions of the left ventricle. Although these findings strongly suggested cardiac amyloidosis, he was finall...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research
Conclusion Our study revealed that QTc dispersion, Tpe and Tpe/QT ratio were greater in sarcoidosis patients compared to the control group. To our knowledge, the present study is the first to use Tpe interval analysis in patients without cardiac involvement in sarcoidosis. Tpe interval and Tpe/QT ratio may be promising markers for cardiovascular morbidity and mortality due to ventricular arrhythmias in patients with and without cardiac involvement in sarcoidosis.
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
Conclusion: The developed method of screening can be used for the selection of patients who require further assessment to exclude cardiac involvement.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Diffuse Parenchymal Lung Disease Source Type: research
Conclusions Of all cardiac tests, CMR was the most valuable in the diagnosis and prognosis of cardiac sarcoidosis in a general sarcoidosis population. Echocardiography had an overall limited diagnostic value as a screening test, and an abnormal study, despite a high positive predictive value, may still need confirmation with CMR.
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - Category: Radiology Authors: Tags: Original Research Source Type: research
A 48-year-old male presented with symptomatic ventricular tachycardia of 226 b.p.m. After external cardioversion, electrocardiogram revealed a complete right bundle branch block but no other abnormalities. Echocardiography showed a reduced left ventricular-function (ejection fraction: 49%) with dyskinesia of the basal septum and anterior wall; however, coronary heart disease was excluded by angiography. On subsequent simultaneous positron emission tomography/magnetic resonance imaging (PET/MRI), a diffuse, band-shaped, mostly subendocardial late gadolinium enhancement was observed within both ventricles particularly within...
Source: European Heart Journal - Category: Cardiology Source Type: research
In this study, our aim was to determine whether novel ECG parameters are associated with pathological PET findings in patients with suspected cardiac sarcoidosis.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
CONCLUSIONS: Extrathoracic disease was more prevalent in WTC-related sarcoidosis than reported for sarcoidosis patients without WTC-exposure or for other exposure-related granulomatous diseases (beryllium disease and hypersensitivity pneumonitis). Cardiac involvement would have been missed if evaluation stopped after electrocardiogram, 48-hour recordings and echocardiogram. Our results also support the need for advanced cardiac screening in asymptomatic patients with strenuous, stressful, public safety occupations, given the potential fatality of a missed diagnosis. PMID: 29066387 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
ConclusionsCurrent consensus guidelines recommend all patients with sarcoidosis undergo screening for occult cardiac disease, with thorough history and examination, electrocardiogram, and transthoracic echocardiogram. If any abnormalities are detected, advanced cardiac imaging should follow. While cardiac magnetic resonance imaging identifies the majority of cardiac sarcoidosis, early disease may not be detected. These cases demonstrate18F-fluorodeoxyglucose-positron emission tomography is warranted following an indeterminate or normal cardiac magnetic resonance imaging if clinical suspicion remains high. Unidentified and ...
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
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