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Speckle tracking echocardiography can predict subclinical myocardial involvement in patients with sarcoidosis: A meta‐analysis
Author(s) -
Barssoum Kirolos,
Altibi Ahmed M.,
Rai Devesh,
Kumar Ashish,
Kharsa Adnan,
Chowdhury Medhat,
Thakkar Samarthkumar,
Shahid Sara,
Abdelazeem Mohamed,
Abuzaid Ahmed Sami,
Baibhav Bipul,
Parikh Vishal,
Feitell Scott C.,
BalmerSwain Mallory,
Rao Mohan,
Amsallem Myriam,
Nanda Navin C.
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14886
Subject(s) - medicine , sarcoidosis , speckle tracking echocardiography , cardiology , subclinical infection , ventricle , confidence interval , meta analysis , cardiac pet , strictly standardized mean difference , magnetic resonance imaging , ejection fraction , radiology , heart failure , perfusion
Background This meta‐analysis aims to evaluate the utility of speckle tracking echocardiography (STE) as a tool to evaluate for cardiac sarcoidosis (CS) early in its course. Electrocardiography and echocardiography have limited sensitivity in this role, while advanced imaging modalities such as cardiac magnetic resonance (CMR) and 18F‐fluorodeoxyglucose positron emission tomography (FDG‐PET) are limited by cost and availability. Methods We compiled English language articles that reported left ventricular global longitudinal strain (LVGLS) or global circumferential strain (GCS) in patients with confirmed extra‐cardiac sarcoidosis versus healthy controls. Studies that exclusively included patients with probable or definite CS were excluded. Continuous data were pooled as a standard mean difference (SMD), comparing sarcoidosis group with healthy controls. A random‐effect model was adopted in all analyses. Heterogeneity was assessed using Q and I2 statistics. Results Nine studies were included in our final analysis with an aggregate of 967 patients. LVGLS was significantly lower in the extra‐cardiac sarcoidosis group as compared with controls, SMD −3.98, 95% confidence interval (CI): −5.32, −2.64, P < .001, also was significantly lower in patients who suffered major cardiac events (MCE), −3.89, 95% CI −6.14, −1.64, P < .001. GCS was significantly lower in the extra‐cardiac sarcoidosis group as compared with controls, SMD: −3.33, 95% CI −4.71, −1.95, P < .001. Conclusion LVGLS and GCS were significantly lower in extra‐cardiac sarcoidosis patients despite not exhibiting any cardiac symptoms. LVGLS correlates with MCEs in CS. Further studies are required to investigate the role of STE in the early screening of CS.