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T wave amplitude in lead aVR as a novel diagnostic marker for cardiac sarcoidosis

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Abstract

It is vital to identify cardiac involvement (CI) in patients with sarcoidosis as the condition could initially lead to sudden cardiac death. Although the T wave amplitude in lead aVR (TWAaVR) is reportedly associated with adverse cardiac events in various cardiovascular diseases, only scarce data are available concerning the utility of lead aVR in identifying CI in patients with sarcoidosis. We retrospectively investigated the diagnostic values of TWAaVR in patients with sarcoidosis in comparison with conventional electrocardiography parameters such as bundle branch block (BBB). From January 2006 to December 2014, 93 consecutive patients with sarcoidosis were enrolled (mean age, 55.7 ± 15.7 years; male, 31 %; cardiac involvement, n = 26). TWAaVR showed the greatest sensitivity (39 %) and specificity (92 %) in distinguishing between sarcoidosis patients with and without CI, at a cutoff value of −0.08 mV. The diagnostic value of BBB for cardiac involvement was significantly improved when combined with TWAaVR (sensitivity: 61–94 %, specificity: 97–89 %, area under the curve: 0.79–0.92, p = 0.018). Multivariate logistic regression analysis indicated that TWAaVR and BBB were independent electrocardiography parameters associated with CI. In summary, we observed that sarcoidosis patients exhibiting a high TWAaVR were likely to have CI. Thus, the application of a combination of BBB with TWAaVR may be useful when screening for CI in sarcoidosis patients.

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Acknowledgments

We would like to thank Mr. Masayuki Yamada for the help with clinical data collection. We also appreciate the useful statistical advice provided by Tadahiro Goto, MD, MPH, Massachusetts General Hospital.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8641, Japan

    Yoshihiro Tanaka, Tetsuo Konno, Shohei Yoshida, Toyonobu Tsuda, Kenji Sakata, Hiroshi Furusho, Masayuki Takamura, Masakazu Yamagishi & Kenshi Hayashi

  2. Research and Education Center for Innovative and Preventive Medicine, Kanazawa University, Kanazawa, 920-8640, Japan

    Tetsuo Konno

  3. Innovative Clinical Research Center, Kanazawa University (iCREK), Kanazawa, 920-8641, Japan

    Kenichi Yoshimura

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  1. Yoshihiro Tanaka
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  2. Tetsuo Konno
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  3. Shohei Yoshida
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  4. Toyonobu Tsuda
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  5. Kenji Sakata
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  7. Masayuki Takamura
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  9. Masakazu Yamagishi
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  10. Kenshi Hayashi
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Correspondence to Tetsuo Konno.

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Tanaka, Y., Konno, T., Yoshida, S. et al. T wave amplitude in lead aVR as a novel diagnostic marker for cardiac sarcoidosis. Heart Vessels 32, 352–358 (2017). https://doi.org/10.1007/s00380-016-0881-3

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  • DOI: https://doi.org/10.1007/s00380-016-0881-3

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