{"title":"斑点追踪超声心动图是印度队列中系统性肉样瘤病患者心脏受累的有效筛查工具：一项前瞻性观察研究。","authors":"Prasanth Areekkara Poduvattil, Zia Hashim, Sudeep Kumar, Neeraj Jain, Manish Ora, Sanjay Gambhir, Mansi Gupta, Ajmal Khan, Alok Nath, Vinita Agrawal","doi":"10.1111/echo.15957","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Diagnosing cardiac sarcoidosis (CS) is challenging due to the lack of a sensitive gold standard diagnostic test. Although advanced imaging techniques like cardiac magnetic resonance imaging (MRI) (cardiovascular magnetic resonance [CMR]) and fluorodeoxyglucose positron emission tomography (FDG-PET) CT are promising, they are limited by their availability and cost. Two-dimensional speckle-tracking echocardiography (2D-STE) is emerging as a valuable tool for the early detection of CS.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This single-center observational study assessed cardiac involvement and the utility of STE as a screening tool for diagnosing CS among newly diagnosed, histologically confirmed, treatment-naïve patients with systemic sarcoidosis in an Indian cohort.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The study included 48 newly diagnosed sarcoidosis patients with a median age of 42.5 years (interquartile range [IQR] 34–53.5), of whom 52.1% were female. FDG-PET CT findings suggested cardiac involvement in 21 patients, while CMR findings were positive in 11 patients. All patients had normal 12-lead ECGs and echocardiograms. Twenty-five patients met the HRS 2014 criteria for CS diagnosis. The median (IQR) left ventricular global longitudinal strain (LV GLS) was −15.4 (−16.2, −13.4) in the probable CS group and −17.9 (−19.4, −17.4) in the non-CS group. An LV GLS cutoff of >−17.3 showed a sensitivity of 80.00% and a specificity of 82.61% (<i>p</i> < 0.001, area under the curve [AUC] = 0.790) for CS diagnosis. A right ventricular global longitudinal strain (RV GLS) cutoff of >−21.4 showed a sensitivity of 68.00% and a specificity of 78.26% (<i>p</i> < 0.017, AUC = 0.692). They both have very high negative predictive value (98.7% and 97.9%) and thus useful for ruling out the cardiac involvement than confirming it.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>STE effectively screens for cardiac involvement in sarcoidosis patients, ruling out CS diagnosis.</p>\n </section>\n </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Speckle-Tracking Echocardiography as an Effective Screening Tool for Cardiac Involvement Among Patients With Systemic Sarcoidosis in an Indian Cohort: A Prospective Observational Study\",\"authors\":\"Prasanth Areekkara Poduvattil, Zia Hashim, Sudeep Kumar, Neeraj Jain, Manish Ora, Sanjay Gambhir, Mansi Gupta, Ajmal Khan, Alok Nath, Vinita Agrawal\",\"doi\":\"10.1111/echo.15957\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Diagnosing cardiac sarcoidosis (CS) is challenging due to the lack of a sensitive gold standard diagnostic test. Although advanced imaging techniques like cardiac magnetic resonance imaging (MRI) (cardiovascular magnetic resonance [CMR]) and fluorodeoxyglucose positron emission tomography (FDG-PET) CT are promising, they are limited by their availability and cost. Two-dimensional speckle-tracking echocardiography (2D-STE) is emerging as a valuable tool for the early detection of CS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This single-center observational study assessed cardiac involvement and the utility of STE as a screening tool for diagnosing CS among newly diagnosed, histologically confirmed, treatment-naïve patients with systemic sarcoidosis in an Indian cohort.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The study included 48 newly diagnosed sarcoidosis patients with a median age of 42.5 years (interquartile range [IQR] 34–53.5), of whom 52.1% were female. FDG-PET CT findings suggested cardiac involvement in 21 patients, while CMR findings were positive in 11 patients. All patients had normal 12-lead ECGs and echocardiograms. Twenty-five patients met the HRS 2014 criteria for CS diagnosis. The median (IQR) left ventricular global longitudinal strain (LV GLS) was −15.4 (−16.2, −13.4) in the probable CS group and −17.9 (−19.4, −17.4) in the non-CS group. An LV GLS cutoff of >−17.3 showed a sensitivity of 80.00% and a specificity of 82.61% (<i>p</i> < 0.001, area under the curve [AUC] = 0.790) for CS diagnosis. A right ventricular global longitudinal strain (RV GLS) cutoff of >−21.4 showed a sensitivity of 68.00% and a specificity of 78.26% (<i>p</i> < 0.017, AUC = 0.692). They both have very high negative predictive value (98.7% and 97.9%) and thus useful for ruling out the cardiac involvement than confirming it.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>STE effectively screens for cardiac involvement in sarcoidosis patients, ruling out CS diagnosis.</p>\\n </section>\\n </div>\",\"PeriodicalId\":50558,\"journal\":{\"name\":\"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques\",\"volume\":\"41 11\",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/echo.15957\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/echo.15957","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Speckle-Tracking Echocardiography as an Effective Screening Tool for Cardiac Involvement Among Patients With Systemic Sarcoidosis in an Indian Cohort: A Prospective Observational Study
Introduction
Diagnosing cardiac sarcoidosis (CS) is challenging due to the lack of a sensitive gold standard diagnostic test. Although advanced imaging techniques like cardiac magnetic resonance imaging (MRI) (cardiovascular magnetic resonance [CMR]) and fluorodeoxyglucose positron emission tomography (FDG-PET) CT are promising, they are limited by their availability and cost. Two-dimensional speckle-tracking echocardiography (2D-STE) is emerging as a valuable tool for the early detection of CS.
Methods
This single-center observational study assessed cardiac involvement and the utility of STE as a screening tool for diagnosing CS among newly diagnosed, histologically confirmed, treatment-naïve patients with systemic sarcoidosis in an Indian cohort.
Results
The study included 48 newly diagnosed sarcoidosis patients with a median age of 42.5 years (interquartile range [IQR] 34–53.5), of whom 52.1% were female. FDG-PET CT findings suggested cardiac involvement in 21 patients, while CMR findings were positive in 11 patients. All patients had normal 12-lead ECGs and echocardiograms. Twenty-five patients met the HRS 2014 criteria for CS diagnosis. The median (IQR) left ventricular global longitudinal strain (LV GLS) was −15.4 (−16.2, −13.4) in the probable CS group and −17.9 (−19.4, −17.4) in the non-CS group. An LV GLS cutoff of >−17.3 showed a sensitivity of 80.00% and a specificity of 82.61% (p < 0.001, area under the curve [AUC] = 0.790) for CS diagnosis. A right ventricular global longitudinal strain (RV GLS) cutoff of >−21.4 showed a sensitivity of 68.00% and a specificity of 78.26% (p < 0.017, AUC = 0.692). They both have very high negative predictive value (98.7% and 97.9%) and thus useful for ruling out the cardiac involvement than confirming it.
Conclusion
STE effectively screens for cardiac involvement in sarcoidosis patients, ruling out CS diagnosis.
期刊介绍：
Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.
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