Role of magnetic resonance in the detection of cardiac involvement in patients with newly diagnosed extracardiac sarcoidosis: Single center experience

BACKGROUND: Sarcoidosis is a systemic inflammatory disease of unknown etiology, which can affect almost any organ. Cardiac involvement determines the prognosis of the affected individuals. Its prevalence in patients with extracardiac sarcoidosis with the absence of cardiac symptoms remains unclear. Cardiac magnetic resonance (CMR) provides an excellent diagnostic accuracy in the detection of the heart involvement by sarcoidosis. AIM: We sought to determine the prevalence of cardiac sarcoidosis in asymptomatic individuals with newly diagnoses extracardiac sarcoidosis using CMR. METHODS: We prospectively evaluated 55 consecutive patients mean (SD) aged 43 (11) years, including 23 women with newly diagnosed extracardiac sarcoidosis who underwent contrast-enhanced CMR and had no symptoms of heart disease. The presence of myocardial late gadolinium enhancement (LGE) of non-ischemic etiology on CMR examination was considered diagnostic for the presence of cardiac sarcoidosis. RESULTS: In 3 (6%) patients LGE pattern consistent with cardiac sarcoidosis was detected. In all these patients, preserved left ventricular systolic regional a well as global function was present and in none of them the elevation of blood biomarkers of myocardial injury or overload was found. CONCLUSIONS: Our study suggests that the prevalence of cardiac involvement in patients with newly diagnosed extracardiac sarcoidosis and no symptoms of heart disease is very low as assesed by CMR.  However, CMR may be considered as a part of routine evaluation of patients with extracardiac sarcoidosis due its higher diagnostic yield in comparison with echocardiography and ECG, respectively