Prognostic impact of atrial function in cardiac sarcoidosis using two-dimensional speckle-tracking echocardiography

Abstract

AbstractAimsAlthough ventricular dysfunction is associated with adverse outcomes in cardiac sarcoidosis (CS), the potential role of atrial function is unknown. The aim of this study was to assess the effect of atrial function on clinical outcomes in patients with CS.MethodsWe retrospectively enrolled 96 patients with CS. Left atrial (LA) and right atrial (RA) function was calculated as LA global longitudinal strain (LAGLS) and RA global longitudinal strain (RAGLS), respectively, using two-dimensional speckle-tracking echocardiography. Major adverse cardiac event (MACE) was a composite of cardiac death, fatal ventricular arrhythmia events, and hospitalization for heart failure.ResultsDuring a median follow-up of 6.0 years, 37 patients had MACE. LAGLS and RAGLS were lower in patients with MACE than in those without MACE. Kaplan-Meier curves showed that patients with atrial dysfunction with LAGLS of ≤ 19.6% or RAGLS of ≤ 22.3% had a higher rate of MACE than those without atrial dysfunction (log-rank test, p = 0.01 for both comparisons). The presence of LAGLS of ≤ 19.6% or RAGLS of ≤ 22.3% was significantly associated with MACE in a model that included age, sex, and New York Heart Association class (hazard ratio: 2.19, 95% confidence interval: 1.06–4.55, p = 0.04; hazard ratio: 2.27, 95% confidence interval: 1.07–4.85, p = 0.03, respectively).ConclusionsAtrial dysfunction represented by LAGLS and RAGLS is associated with adverse outcomes in patients with CS. Our findings suggest a potential role of atrial function for predicting the prognosis in CS.