Abstract
Aim: To correlate presenting symptoms with a final diagnosis of cardiac sarcoid & determine prognostic characteristics for mortality
Methods: Retrospective analysis of 503 consecutive patients with sarcoidosis presenting between 2006-2016 to Papworth & Cambridge University Hospitals. Cardiac symptoms (specifically syncope, palpitations, chest pain) were correlated with diagnosis of cardiac sarcoidosis. Transplant-free survival analysis was performed. Prognostic markers were identified using uni- & multivariable logistic regression.
Results: 27 patients (5.4%) were diagnosed with cardiac involvement. Presentation with cardiac symptoms was correlated with a diagnosis of cardiac sarcoid (p=0.006) though the overall predictive value was poor with a ROC of 0.62 (95% CI 0.51-0.73) due to a high false negative rate (65%) & a false positive rate of 10%. A diagnosis of cardiac involvement carried no significant increase in mortality/transplant rate compared with non-cardiac sarcoid (7.4% vs 6.3%). It was not associated with a worse transplant-free survival probability in multivariate regression (adjusted for age, stage, and TLCO % predicted) whereas a presentation with cardiac symptoms adjusted for the same confounders was (HR 4.8, 95% CI 1.2-19.2, p=0.03) Inclusion of pulmonary hypertension in the model did not change overall outcome.
Conclusion: Cardiac symptoms are an important but unreliable marker for cardiac sarcoidosis. This series' poor specificity highlights the importance of cardiac screening. The fact that mortality is comparable to non-cardiac cases is a testament to treatment advances. Cardiac symptoms at presentation do however carry a poor prognosis possibly due to being a marker of other underlying cardiac morbidity.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3011.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020