Table 1A.
Retrospective delayed contrast‐enhanced cardiac magnetic resonance studies evaluating the association between late gadolinium enhancement and adverse outcomes in cardiac sarcoidosis
| Authors | Study | Study population |
Follow‐up (months) |
Endpoints | Events | CMR findings | Predictive value for endpoints | |
|---|---|---|---|---|---|---|---|---|
| Positive (%) | Negative (%) | |||||||
| Shafee et al. (2012)5 | Retrospective single‐centre | 37 pts, large percentage symptomatic CS, 68% female, Japanese | 45 |
Primary: nsVT/sVT |
8 |
LV LGE + for secondary endpoint LV LGE in 70% |
31 | 100 |
|
Secondary: CD/VT/CCF |
11 | |||||||
| Crawford et al. (2014)7 | Retrospective multi‐centre |
51 pts, all CS, all LVEF > 35%, 84% female, 47% African American, 45% Caucasian, 47% steroids, 31 ICDs |
48 |
Composite: Death/VT/VF |
15 |
Any LGE + multi‐focal LGE + RV LGE + LV LGE in 63%, 14.5±12.1%, 13/32 also had RV LGE, these pts had more extensive LV LGE multi‐focal LGE correlated with VT/VF |
22 | 100 |
| 3 CD | 48 | 97 | ||||||
| 12 VT/VF | 100 | 97 | ||||||
| Ise et al. (2014)8 | Retrospective single‐centre |
43 pts, all CS‐LGE positive pts, 65% female, Japanese, all treated with steroids, 7 ICDs |
39 |
Composite: CD/VT/VF/CCF |
23 | LV LGE ≥ 21.9% of LV mass steroid treatment improved LVEF in pts with small amounts of LGE | 62 | 86 |
| 6 CD | ||||||||
| 11 VT/VF | ||||||||
| Nadel et al. (2015)10 | Retrospective single‐centre | 106 pts, systemic sarcoidosis ‐70% pulmonary, 32 CS‐CMR defined by LGE, 40% female, 58% steroids, 19 ICDs | 36.8 | Primary: | 12 |
LGE + for primary endpoint LGE + for secondary endpoints LV LGE only independent predictor of composite cardiovascular endpoint (HR 12.52) |
38 | 99 |
| SCD/VT/VF | 4 SCD | |||||||
| Secondary: | ||||||||
| •all‐cause mortality | 12 | 13 | 89 | |||||
| •SCD/appropriate ICD shock | 7 | 19 | 99 | |||||
| •SCD/VT/VF/AVB/CCF appropriate ICD shock | 37 | 97 | 92 | |||||
| Ekström et al. (2016)11 | Retrospective single‐centre | 59 pts, 50 CS pts, 48 with LV LGE, not reported on RV LGE, 64% female, Scandinavian, 35 ICDs | 26 |
Composite: CD/VT/VF/heart transplantation |
23 |
LV LGE > 22% LV LGE > 22% or VT/VF at presentation LV LGE extent and RVEF correlated with adverse outcome |
75 | 76 |
| 3 CD | 74 | 92 | ||||||
| 5 VF | ||||||||
| 14 VT | ||||||||
| Murtagh et al. (2016)12 | Retrospective single‐centre |
205 pts, extra‐cardiac sarcoidosis, LVEF > 50% 69% female, 59% African American, 60% steroids, 6 ICDs |
36 |
Composite: Death/VT |
12 8 ACD |
LGE + LGE in 20% of pts for every 1% increase in LGE burden the hazard for an event increased 8% | 32 | 99 |
| Agoston et al. (2016)13 | Retrospective single‐centre | 56 pts, all CS as defined by presence of LGE, 67% female, 52% steroids | 32 |
Composite: Death/appropriate ICD shock/nsVT /sVT/AVB/CCF |
16 1 CD 1 VT 10 CCF |
LV LGE > 18 g associated with adverse outcome | 54 | 96 |
| Yasuda et al. (2016)14 | Retrospective multi‐centre |
81pts, definite or suspected CS, 60.5% female, Japanese, 38.3% nsVT/sVT, 24.7% high degree AVB, 29.6% CCF, 52% steroids, 8 ICDS |
22.1 |
Composite: AVB/CCF/nsVT/sVT/appropriate ICD therapy/CD |
30 3 CD 12 VT 7 CCF 4 PM |
LV LGE in 94.9% of pts RV LGE in 57% of pts LV LGE 16.6±12.8% LGE ≥ 5.12 g/m2 sens 86%/spec 62% for VT/VF No events when LGE < 5.12 g/m2 and LV LGE ≤ 1 basal anteroseptal segment/RV LGE |
||
ACD, all‐cause death; AVB, atrio‐ventricular block; CCF, congestive cardiac failure; CD, cardiac death; CMR, cardiovascular magnetic resonance; CS, cardiac sarcoidosis; HR, hazard ratio; ICD, implantable cardioverter defibrillator; LGE, late gadolinium enhancement; LV, left ventricle; LVEF, left ventricular ejection fraction; nsVT, non‐sustained ventricular tachycardia; PM, pacemaker; pts, patients; RV, right ventricle; SCD, sudden cardiac death; sVT, sustained ventricular tachycardia; VF, ventricular fibrillation; VT, ventricular tachycardia.