Speckle Tracking Echocardiography Can Predict Subclinical Myocardial
Involvement in Patients with Sarcoidosis: A Meta-Analysis
Abstract
Background This meta-analysis aims to evaluate the utility of speckle
tracking echocardiography (STE) as a tool to evaluate for cardiac
sarcoidosis (CS) early in its course. Electrocardiography and
echocardiography have limited sensitivity in this role, while advanced
imaging modalities such as cardiac magnetic resonance (CMR) and
18F-Fluorodeoxyglucose–Positron Emission Tomography (FDG-PET) are
limited by cost and availability. Methods We compiled English language
articles that reported left ventricular global longitudinal strain
(LVGLS) or global circumferential strain (GCS) in patients with
confirmed extra-cardiac sarcoidosis versus healthy controls. Studies
that exclusively included patients with probable or definite CS were
excluded. Continuous data were pooled as a standard mean difference
(SMD) between the sarcoidosis group and controls. A random effect model
was adopted in all analyses. Heterogeneity was assessed using Q and I2
statistics. Results Nine studies with 967 patients were included in our
analysis. LVGLS was significantly lower in the extra-cardiac sarcoidosis
group as compared to controls, SMD -3.98, 95% confidence interval (CI):
-5.32, -2.64, p< 0.001, also was significantly lower in
patients who suffered Major Cardiac Events(MCE), -3.89, 95% CI -6.14,
-1.64, p< 0.001 . GCS was significantly lower in the
extra-cardiac sarcoidosis group as compared to controls, SMD: -3.33,
95% CI -4.71, -1.95, p< 0.001 Conclusion LVGLS and GCS were
significantly lower in extra-cardiac sarcoidosis patients despite not
exhibiting any cardiac symptoms. LVGLS correlates with MCEs in CS.
Further studies are required to investigate the role of STE in the early
screening of CS.