Myocardial contractile patterns predict future cardiac events in sarcoidosis

  • Jian Chen
  • Juan Lei
  • Ernest Scalzetti
  • Mary McGrath
  • David Feiglin
  • Robert Voelker
  • Jingfeng Wang
  • Michael C. Iannuzzi
  • Kan Liu
Original Paper


The poor prognosis of cardiac sarcoidosis (CS) underscores the need for risk stratification. We evaluated 84 consecutive sarcoidosis patients who were referred for echocardiographic studies for cardiac symptoms or abnormal electrocardiograms. In 54 patients without previous diagnosis of CS or other known structural heart disease, 13 reached endpoints during (median) 24 months follow up. Significantly impaired peak systolic longitudinal strain in their original echocardiograms were identified in 13 of 17 left ventricular segments, clustering in the free wall, interventricular septum and apex. The regional (including 13 clustered segments) peak systolic longitudinal strain (RPSLS) were significantly impaired in patients with endpoints, compared with those without [(−11.4 ± 4.45) vs. (−18.7 ± 3.76) %, P < 0.00001]. Cox multivariate regression analysis revealed that RPSLS was independently associated with endpoints (HR 1.24; 95% CI 1.08–1.42, P = 0.002). Receiver operating characteristic curve suggested a cut-off RPSLS value of −15.0% (84.6% sensitivity and 86.8% specificity) to predict the occurrence of endpoints. Impaired RPSLS correlates with risk of adverse cardiac events in patients with extra-cardiac sarcoidosis.


Risk stratification Regional peak systolic longitudinal strain Cardiac sarcoidosis 



Late peak diastolic velocities across mitral valve


Area under the receiver operating characteristic curve


Coronary artery disease


Cardiac magnetic resonance imaging


Cardiac sarcoidosis


Early peak diastolic velocities across mitral valve


Early diastolic mitral annulus (myocardial) velocity




18F-2-Fluoro-2-Deoxyglucose positron emission tomography


Heart Rhythm Society


Interventricular septal dimensions


Japanese Ministry of Health and Welfare


Left ventricular


Left ventricular end diastolic dimensions


Left ventricular end diastolic volumes


Left ventricular ejection fraction


Left ventricular end systolic dimensions


Left ventricular end systolic volumes


Regional peak systolic longitudinal strain


Posterior wall diameters


Receiver operating characteristic


Systolic mitral annulus (myocardial) velocity


Tissue Doppler imaging




Author contributions

KL, MCI, and JFW: Conception and design of the study; JC, JL, ES, MM, DF, RV: acquisition and analysis of data; JC, JL, ES, MM, DF: interpretation of data; KL, MCI, JFW, JL: drafting the work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

This study is approved by institutional research board of Human Subjects Committee of State University of New York Upstate Medical University.

Informed consent

Not applicable.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Jian Chen
    • 1
    • 2
  • Juan Lei
    • 1
    • 3
  • Ernest Scalzetti
    • 4
  • Mary McGrath
    • 4
  • David Feiglin
    • 4
  • Robert Voelker
    • 1
  • Jingfeng Wang
    • 3
  • Michael C. Iannuzzi
    • 5
  • Kan Liu
    • 1
  1. 1.Division of CardiologyState University of New York, Upstate Medical University HospitalSyracuseUSA
  2. 2.Department of Cardiology, The Fifth Affiliated HospitalSun Yat-Sen UniversityZhuhaiChina
  3. 3.Department of Cardiology, Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhouChina
  4. 4.Department of RadiologyState University of New York, Upstate Medical University HospitalSyracuseUSA
  5. 5.Department of Internal MedicineState University of New York, Upstate Medical University HospitalSyracuseUSA

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