Background : Sarcoidosis is a multiple organ granulomatous disease of undefined cause. Although cardiac involvement often leads to adverse outcomes in patients with sarcoidosis, diagnosis of cardiac sarcoidosis(CS)remains difficult due to the lack of sensitive diagnostic tests.
Purpose : To determine an appropriate combination of diagnostic tests for detecting CS.
Method and Results : Thirteen patients were diagnosed with CS from December 2006 to November2010by the use of2006revised guidelines for diagnosing CS of the Japanese Society of Sarcoidosis and Other Granulomatous Disorders. Positive rate of each major or minor criterion in the guidelines was examined. We also evaluated positive rate of each diagnostic test. In the major criteria, basal thinning of the ventricular septum showed a high positive rate of71.4%, although the others were less than50%. In the minor criteria, positive rates of abnormal electrocardiogram findings and abnormal echocardiogram were76.9% and84.6%, respectively. Late gadolinium enhancement (LGE)of the myocardium on cardiac MRI scanning(CMR)showed a positive rate of100% ; however, CMR was not performed in four patients due to life-threatening arrhythmia. All13patients showed abnormal findings at least in either echocardiogram or LGE on CMR.
Conclusion : Echocardiography is a convenient diagnostic test for detecting CS. The combination of cardiac MRI and echocardiography may improve diagnostic sensitivity