Key result
Atrial dysfunction, represented by left atrial global longitudinal strain ≤ 19.6% (HR 2.19) or right atrial global longitudinal strain ≤ 22.3% (HR 2.27), was associated with increased MACE risk.
Why the study?
Although ventricular dysfunction is linked to adverse outcomes in cardiac sarcoidosis, the potential prognostic role of atrial function remains unknown.
Does atrial dysfunction measured by 2D speckle-tracking echocardiography predict major adverse cardiac events in patients with cardiac sarcoidosis?
Cohort (n=96)
No
Does atrial dysfunction measured by 2D speckle-tracking echocardiography predict major adverse cardiac events in patients with cardiac sarcoidosis?
Hazard Ratio: 2.19 (95% CI 1.06–4.55)
p-value: p=0.04
Atrial dysfunction assessed by 2D speckle-tracking echocardiography is independently associated with adverse clinical outcomes in patients with cardiac sarcoidosis.
May aid CS risk stratification beyond ventricular metrics; leaves open incremental value pending prospective validation.
Aims Although ventricular dysfunction is associated with adverse outcomes in cardiac sarcoidosis (CS), the potential role of atrial function is unknown. The aim of this study was to assess the effect of atrial function on clinical outcomes in patients with CS. Methods We retrospectively enrolled 96 patients with CS. Left atrial (LA) and right atrial (RA) function was calculated as LA global longitudinal strain (LAGLS) and RA global longitudinal strain (RAGLS), respectively, using two-dimensional speckle-tracking echocardiography. Major adverse cardiac event (MACE) was a composite of cardiac death, fatal ventricular arrhythmia events, and hospitalization for heart failure. Results During a median follow-up of 6.0 years, 37 patients had MACE. LAGLS and RAGLS were lower in patients with MACE than in those without MACE. Kaplan-Meier curves showed that patients with atrial dysfunction with LAGLS of ≤ 19.6% or RAGLS of ≤ 22.3% had a higher rate of MACE than those without atrial dysfunction (log-rank test, p = 0.01 for both comparisons). The presence of LAGLS of ≤ 19.6% or RAGLS of ≤ 22.3% was significantly associated with MACE in a model that included age, sex, and New York Heart Association class (hazard ratio: 2.19, 95% confidence interval: 1.06–4.55, p = 0.04; hazard ratio: 2.27, 95% confidence interval: 1.07–4.85, p = 0.03, respectively). Conclusions Atrial dysfunction represented by LAGLS and RAGLS is associated with adverse outcomes in patients with CS. Our findings suggest a potential role of atrial function for predicting the prognosis in CS.
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Nishihara et al. (2023) conducted a cohort in Cardiac sarcoidosis (n=96). Left atrial global longitudinal strain (LAGLS) ≤ 19.6% vs. LAGLS > 19.6% was evaluated on Major adverse cardiac event (MACE), a composite of cardiac death, fatal ventricular arrhythmia events, and hospitalization for heart failure (HR 2.19, 95% CI 1.06-4.55, p=0.04). Atrial dysfunction, represented by left atrial global longitudinal strain ≤ 19.6% (HR 2.19) or right atrial global longitudinal strain ≤ 22.3% (HR 2.27), was associated with increased MACE risk.
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