INVASIVE AND NONINVASIVE DIAGNOSIS OF CARDIAC SARCOIDOSIS: A CASE SERIES

TOPIC: Cardiovascular Disease TYPE: Original Investigations PURPOSE: Sarcoidosis is a multiorgan system granulomatous disease of unknown etiology. It hypothesized that combination environmental, occupational, and/or infectious factors provoke an immunological response in genetically susceptible individuals, resulting diversity manifestations throughout the body[1]. In United States, cardiac sarcoidosis (CS) diagnosed 5% patients with systemic sarcoidosis, however, autopsy results suggest involvement may be present >50% patients[2-4]. CS debilitating and significantly decreases quality life survival. Currently, there are no gold-standard clinical diagnostic or monitoring criteria for CS. METHODS: We identified diagnosis who were seen at Simmons Center from 1991 to 2020 had positive finding documented CMR endomyocardial biopsy as found electronic medical record. Medical records independently reviewed interpretation features including late gadolinium enhancement (LGE) patterns, increased signal on T2-weighted imaging, noncaseating granulomas, respectively. Extracardiac organ involvement, manifestations, comorbid conditions, treatment history, vital status also abstracted. RESULTS: 44 unique evidence out 246 reports 9 pathology reports. The first eligible case was 2007. majority (73%) pulmonary followed by hepatic (23%), cutaneous urolithiasis (20%). Heart failure most common manifestation affecting 59% patients. Of these, 39% left ventricular ejection fraction (LVEF) <50% CMR. Fifty eight percent conduction 44% arrhythmias. Pharmacotherapy usually initiated extracardiac 93% been prescribed prednisone. ICD implantation occurred 43% Patients up median 5.4 (IQR: 2.4-8.5) years. 10-year survival 70% (Figure 1). addition age, associated risk death (age-adjusted OR = 8.4: 95% CI 1.14-67.89). CONCLUSIONS: important tool noninvasive CS, which has higher sensitivity than biopsy. presence LGE pattern consistent shown predictor mortality [5-7] likely contributed high proportion undergoing decrease sudden death. CLINICAL IMPLICATIONS: Additional studies necessary develop robust CMR, assess benefit serial imaging monitoring, evaluate effect immunosuppression progression. DISCLOSURES: No relevant relationships Tiffany Brazile, source=Web Response disclosure file Kevin Gibson; Seyed Mehdi Nouraie, Melissa Saul,