Presence of Late Gadolinium Enhancement by Cardiac Magnetic Resonance Among Patients With Suspected Cardiac Sarcoidosis Is Associated With Adverse Cardiovascular Prognosis: A Systematic Review and Meta-Analysis

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art_HULTEN_Presence_of_Late_Gadolinium_Enhancement_by_Cardiac_Magnetic_2016.PDF (1.15 MB)
Citações na Scopus
156
Tipo de produção
article
Data de publicação
2016
Editora
LIPPINCOTT WILLIAMS & WILKINS
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
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Título do Volume
Autores
HULTEN, Edward
AGARWAL, Vikram
CAHILL, Michael
COLE, Geoff
VITA, Tomas
PARRISH, Scott
MURTHY, Venkatesh L.
KWONG, Raymond
CARLI, Marcelo F. Di
Autor de Grupo de pesquisa
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Coordenadores
Organizadores
Citação
CIRCULATION-CARDIOVASCULAR IMAGING, v.9, n.9, article ID e005001, 9p, 2016
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Background Individuals with cardiac sarcoidosis have an increased risk of ventricular arrhythmia and death. Several small cohort studies have evaluated the ability of late gadolinium enhancement (LGE) by cardiac magnetic resonance imaging (MRI) to predict adverse cardiovascular events. However, studies have yielded inconsistent results, and some analyses were underpowered. Therefore, we sought to systematically review and perform meta-analysis of the prognostic value of cardiac MRI for patients with known or suspected cardiac sarcoidosis. Methods and Results We systematically searched for cohort studies of patients with known sarcoidosis with suspected cardiac involvement who underwent cardiac MRI with LGE with at least 12 months of either prospective or retrospective follow-up data regarding post-MRI adverse cardiovascular outcomes. We identified 7 studies of 694 subjects (mean age 53; 42% men).One hundred and ninety-nine patients (29%) were LGE positive. All-cause mortality occurred in 19 LGE-positive versus 17 LGE-negative subjects (annualized incidence, 3.1% versus 0.6%). The pooled relative risk was 3.38 (95% confidence interval, 1.07-10.7; P=0.04). Cardiovascular mortality occurred in 10 LGE-positive versus 2 LGE-negative subjects (annualized incidence, 1.9% versus 0.3%; relative risk 10.7 [95% confidence interval, 1.34-86.3]; P=0.03). Ventricular arrhythmia occurred in 41 LGE-positive versus 0 LGE-negative subjects (annualized incidence, 5.9% versus 0%; relative risk 19.5 [95% confidence interval, 2.68-143]; P=0.003). A combined end point of death or ventricular arrhythmia occurred in 64 LGE-positive versus 18 LGE-negative subjects (annualized incidence, 8.8% versus 0.6%; relative risk 6.20 [95% confidence interval, 2.47-15.6]; P<0.001). There was no significant heterogeneity for any outcomes. Conclusions LGE is associated with future cardiovascular death and ventricular arrhythmia among patients referred to MRI for known or suspected cardiac sarcoidosis.
Palavras-chave
cardiac arrhythmia, cardiomyopathies, heart conduction system, magnetic resonance imaging, sarcoidosis
URI
https://observatorio.fm.usp.br/handle/OPI/17310
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Coleções
Artigos e Materiais de Revistas Científicas - HU
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - ODS/03