Cardiac Sarcoidosis May Be Predicted with New Technique Via Common Tests

Researchers at the National Research Institute of TB & Lung Diseases, in Poland, have developed a novel tool that helps identify patients with cardiac sarcoidosis via easily accessible and cost-effective tests.

The study “Prevalence of cardiac sarcoidosis in white population: a case–control study: Proposal for a novel risk index based on commonly available tests,” published in the journal Medicine, demonstrated that nearly a quarter of sarcoidosis patients have cardiac manifestations and that using common tests could earlier predict which sarcoidosis patients are most at risk.

Patients with cardiac sarcoidosis are often characterized by poor prognosis. Sudden cardiac death and advanced heart block are common manifestations.  Although autopsy studies have reported involvement of cardiac sarcoidosis in about one-fourth of the study cases, only 2-7 percent of the patients were actually diagnosed with the condition.

In the recent study, researchers aimed to evaluate the prevalence of active cardiac involvement in a group of patients already diagnosed with pulmonary sarcoidosis. In addition, the team looked for heart related factors that could help predict which patients had heart manifestations.

The case-control study enrolled 201 sarcoidosis patients who were subjected to cardiac magnetic resonance (CMR) imaging to confirm or exclude cardiac involvement. Given than CMR imaging is inconclusive for cardiac sarcoidosis in patients with cardiac diseases, four patients with cardiac diseases were excluded from the analysis.

Cardiac sarcoidosis was identified via CMR in 49 patients, accounting for 24.4% of the patients analyzed which was consistent with previous data from autopsies. An analysis showed that male patients were 2.5 times more likely to develop cardiac sarcoidosis. Those with cardiac-related symptoms or extrathoracic sarcoidosis had nearly 3.5 times more chance of developing the disease.

Similar findings were observed for those with elevated serum levels of a peptide that can indicate heart failure, electrocardiography abnormalities, or radiological progression sarcoidosis in the lung. Those findings increased the risk for cardiac sarcoidosis by 3.8 times, 5.4 times, and 3 times, respectively.

Using a multivariate model to predict cardiac sarcoidosis based on these risk factors, the researchers were able to achieve an accuracy of 82%, a sensitivity of 50%, and a specificity of 94%.

The researchers concluded that “a CS (cardiac sarcoidosis) Risk Index based on the results of easily accessible tests is cost-effective and may help to identify patients who should be urgently referred for further diagnostic procedures.”