Key result
Extracardiac sarcoidosis links to early LV-GLS impairment beyond ~4.5 years of disease duration.
Why the study?
Prior studies using speckle-tracking echocardiography to detect subtle cardiac dysfunction in extracardiac sarcoidosis were mostly retrospective, heterogeneous, and primarily focused on left ventricular function.
Does speckle-tracking echocardiography detect subclinical biventricular and biatrial dysfunction in patients with extracardiac sarcoidosis without fibrotic pulmonary involvement compared to healthy controls?
Does speckle-tracking echocardiography detect subclinical biventricular and biatrial dysfunction in patients with extracardiac sarcoidosis without fibrotic pulmonary involvement compared to healthy controls?
Speckle-tracking echocardiography reveals early, subclinical biventricular and biatrial dysfunction in patients with extracardiac sarcoidosis, the extent of which correlates strongly with disease duration.
May unmask subclinical dysfunction in extracardiac sarcoidosis; leaves open prognostic value and need for prospective validation.
Background: Speckle-tracking echocardiography (STE) has been increasingly used to uncover subtle cardiac dysfunction in patients with extracardiac sarcoidosis (ECS) who show no clinical evidence of heart disease. However, prior investigations were mostly retrospective, methodologically heterogeneous, and focused primarily on left ventricular (LV) function. We conducted a prospective study to provide a broader evaluation of myocardial deformation across both ventricles and atria in ECS without fibrotic pulmonary involvement. Methods: Forty-one patients with ECS (mean age 57.4 ± 10.2 years; 58.5% male) and 30 age- and sex-matched controls without ECS and without known structural heart disease (58.5 ± 11.1 years; 53.3% male) were enrolled. All participants underwent conventional transthoracic echocardiography (TTE) supplemented by comprehensive STE analysis of ventricular and atrial function. Subclinical myocardial dysfunction was defined as LV global longitudinal strain (GLS) less negative than −20%, and potential predictors were analyzed. Results: Standard TTE did not show echocardiographic features suggestive of overt infiltrative cardiomyopathy but revealed higher E/average e′ ratios in the ECS group, suggesting subtle diastolic dysfunction. While traditional indices of biventricular systolic function remained preserved, STE demonstrated significant reductions in LV-GLS, LV global circumferential strain, right ventricular-GLS, and both left and right atrial reservoir strain. Multivariate analysis identified disease duration as the sole independent determinant of LV-GLS impairment (OR 2.26, 95%CI 1.10–4.65; p = 0.03). A disease duration of ≥4.5 years predicted abnormal GLS with 88% sensitivity and 75% specificity (AUC 0.89; 95%CI 0.76–1.00). Conclusions: ECS without fibrotic pulmonary involvement is associated with early impairment of biventricular and biatrial strain despite preserved conventional function. The extent of dysfunction correlates strongly with disease duration, underscoring the value of STE for early detection and monitoring.
No takes yet. Share an insight, caveat, or question.
Sonaglioni et al. (2026) studied this question. In extracardiac sarcoidosis without fibrotic lung involvement, LV-GLS impairment occurs early and correlates with disease duration ≥4.5 years (88% sensitivity, 75% specificity).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: