Right ventricular involvement in cardiac sarcoidosis demonstrated with cardiac magnetic resonance

Jan-Peter Smedema*, Robert-Jan van Geuns, Gillian Ainslie, Joris Ector, Hein Heidbuchel, Harry J. G. M. Crijns

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aims Cardiac involvement in sarcoidosis is reported in up to 30% of patients. Left ventricular involvement demonstrated by contrast-enhanced cardiac magnetic resonance has been well validated. We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis.

Methods and results We prospectively evaluated 87 patients diagnosed with pulmonary sarcoidosis with contrast-enhanced cardiac magnetic resonance for right ventricular involvement. Pulmonary artery pressures were non-invasively evaluated with Doppler echocardiography. Patient characteristics were compared between the groups with and without right ventricular involvement, and right ventricular enhancement was correlated with pulmonary hypertension, ventricular mass, volume, and systolic function. Left ventricular late gadolinium enhancement was demonstrated in 30 patients (34%). Fourteen patients (16%) had right ventricular late gadolinium enhancement, with sole right ventricular enhancement in only two patients. The pattern of right ventricular enhancement consisted of right ventricular outflow tract enhancement in 1 patient, free wall enhancement in 8 patients, ventricular insertion point enhancement in 10 patients, and enhancement of the right side of the interventricular septum in 11 patients. Pulmonary arterial hypertension correlated with the presence of right ventricular enhancement (P

Conclusions Right ventricular enhancement was present in 16% of patients diagnosed with pulmonary sarcoidosis and in 48% of patients with left ventricular enhancement. The presence of right ventricular enhancement correlated with pulmonary arterial hypertension, right ventricular systolic dysfunction, hypertrophy, and dilation.

Original languageEnglish
Pages (from-to)535-544
Number of pages10
JournalEsc heart failure
Volume4
Issue number4
DOIs
Publication statusPublished - Nov 2017

Keywords

  • Cardiomyopathy
  • Magnetic resonance imaging
  • Pulmonary hypertension
  • Right ventricle
  • Sarcoidosis
  • PULMONARY-HYPERTENSION
  • RIGHT HEART
  • DIAGNOSIS
  • THERAPY
  • CARDIOMYOPATHY
  • ENHANCEMENT
  • ASSOCIATION
  • GUIDELINES

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