Prevalence of Echocardiographic Features Suggesting Cardiac Sarcoidosis in Patients With Pacemaker or Implantable Cardiac Defibrillator
Korean Circulation Journal 2011³â 41±Ç 6È£ p.313 ~ p.320
¼±º´ÁÖ(Sun Byung-Joo) - University of Ulsan College of Medicine Division of Cardiology
ÀÌÇÊÇü(Lee Pil-Hyung) - University of Ulsan College of Medicine Division of Cardiology
ÃÖÇü¿À(Choi Hyung-Oh) - University of Ulsan College of Medicine Division of Cardiology
¾ÈÁ¤¹Î(Ahn Jung-Min) - University of Ulsan College of Medicine Division of Cardiology
¼Á¤¼÷(Seo Jeong-Sook) - University of Ulsan College of Medicine Division of Cardiology
±è´ëÈñ(Kim Dae-Hee) - University of Ulsan College of Medicine Division of Cardiology
¼ÛÁ¾¹Î(Song Jong-Min) - University of Ulsan College of Medicine Division of Cardiology
ÃÖ±âÁØ(Choi Kee-Joon) - University of Ulsan College of Medicine Division of Cardiology
°´öÇö(Kang Duk-Hyun) - University of Ulsan College of Medicine Division of Cardiology
¼ÛÀç°ü(Song Jae-Kwan) - University of Ulsan College of Medicine Division of Cardiology
Abstract
Background and Objectives: Basal septal thinning or localized aneurysmal dilatation without coronary artery disease has been described as a characteristic finding suggestive of cardiac sarcoidosis. We sought to assess the prevalence of this characteristic echocardiographic finding in patients with pacemaker (PM) or implantable cardiac defibrillator (ICD).
Subjects and Methods: Echocardiography of patients who received PM or ICD were retrospectively analyzed. Patients with marked thinning and akinesia confined to the basal septum (type 1), or posterolateral wall resulting in localized aneurysmal outward bulging (type 2) without history of myocardial infarction or significant coronary stenosis were included for analysis.
Results: Among 1,357 consecutive patients, 21 exhibited suggestive echocardiographic findings (type 1/2=15/6) with a mean ejection fraction of 37¡¾11%. The prevalence was 1.2% in the PM group and 4.0% in the ICD group. Only 3 patients showed histologically confirmable sarcoidosis in lymph nodes, lung and heart, respectively. Endomyocardial biopsy was attempted in 6 patients, but failed to demonstrate sarcoidosis. The 1-, 2-, 4- and 6-year clinical events (death, cardiac transplantation and hospital admission)-free survival rates were 100%, 85.7¡¾7.6%, 75.0¡¾9.7% and 48.6¡¾12.4%, respectively. During follow-up, two patients with PM underwent ICD implantation, and another underwent heart transplantation.
Conclusion: Prevalence of echocardiographic features suggesting prevalence of cardiac sarcoidosis is low in patients who underwent device implantation. However, considering the very low yield of endomyocardial biopsy and the rare extracardiac manifestations in cardiac sarcoidosis, characteristic echocardiographic findings could be an adjunctive diagnostic criterion in these patients.
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Sarcoidosis, Echocardiography, Pacemaker, Implantable cardioverter-defibrillators
KMID :
0368120110410060313
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Prevalence of echocardiographic features suggesting prevalence of cardiac sarcoidosis is low in patients who underwent device implantation.