Echocardiographic parameters in suspected cardiac sarcoidosis patients-the role of speckle tracking strain analysis in the diagnosis of cardiac sarcoidosis

Introduction: Screening suspected cardiac sarcoidosis (CS) patients includes echocardiography but the sensitivity of the modality is significantly lower compared to CMR and cardiac PET. Speckle tracking strain analysis is considered to be helpful in detection of early myocardial dysfunction. Objectives: To assess the diagnostic value of all available echocardiographic parameters in patients with suspected CS and delineate the role of speckle-tracking analysis. Methods: Echocardiography including global logitudinal (GLS), circumferential (GCS) and radial (GRS) strain measurements was used for screening 229 suspected CS patients. A contrast enhanced CMR was performed in all patients and a cardiac PET followed when CMR was suggestive of CS. Results: CS was diagnosed in 50.7% patients based on the HRS criteria. Analysing the echocardiographic parameters in isolation, LV end-diastolic volume index (OR:1.04,95%CI: 1.01-1.07, p=0.006), GCS (OR:1.09,95%CI:1.02-1.16, p=0.013) and RV diameter (OR:2.63,95% CI:1.51-4.55, p=0.001) were independently associated with CS in multivariate regression analysis. Male gender, hypertension, ECG abnormalities and BNP were also significantly correlated with CS in univariate analysis. Male gender (OR:3.26,95%CI:1.54-6.88, p=0.002), BNP (OR:1.01,95%CI:1-1.02, p=0.013), GCS (OR:1.11,95%CI:1.04-1.18, p=0.002) and RV diameter (OR:2.11,95%CI:1.16-3.83, p=0.014) remained independently correlated with CS in multivariate analysis along with independent echocardiographic predictors. Conclusion: In a cohort of suspected CS patients GCS may provide significant diagnostic information and guide advanced imaging for CS.