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Cardiovascular Disease |

Increased Spatial QRS-T Angle in First-Diagnosed Sarcoidosis Patients as a Marker of Cardiac Involvement

Elias Gialafos, PhD; Vasileios Kouranos, MD; Aggeliki Rapti, MD; Efrosyni Manali, MD; Konstantina Aggeli, MD; Elias Perros, MD; Theodore Papaioannou, PhD; Petros Sfikakis, PhD; Christodoulos Stefanadis, PhD; George Tzelepis, PhD; Athol Wells, PhD; Nikolaos Koulouris, PhD
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General Hospital of Chest Diseases "Sotiria", Athens, Greece


Chest. 2014;145(3_MeetingAbstracts):86A. doi:10.1378/chest.1793942
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Abstract

SESSION TITLE: Cardiovascular Disease Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Spatial QRS T-angle (spQRS T-a) is considered as a novel electrocardiography derived marker of independent predictive value of electrical instability in cardiac disease. Cardiac involvement in sarcoidosis is often underdiagnosed, although a significant contributor to mortality. The present study was conducted to test the hypothesis that patients with sarcoidosis have increased ventricular repolarisation heterogeneity as reflected by spQRS-Ta values.

METHODS: This cross-sectional study included newly diagnosed consecutive patients with biopsy proven sarcoidosis (n=83) and healthy subjects (n=83) who were matched 1:1 for age, gender and BMI. All patients underwent clinical and cardiopulmonary evaluation including cardiac MRI to assess spQRS T-a values and cardiac involvement and identify possible correlations.

RESULTS: SpQRS-Ta was significantly increased in sarcoidosis patients compared to healthy controls (18.3 ± 11.4 vs. 11.3 ± 5.1, p<0.01). When known criteria for the clinical diagnosis of cardiac sarcoidosis were applied spQRS-Ta was found significantly increased in patients with presence of criteria compared to totally ‘negative’ sarcoidosis patients (21.1 ± 11.8 vs. 15.8 ± 10.4, p=0.03). SpQRS-Ta values were significantly greater in those sarcoidosis patients with Lown class >III ventricular arrhythmia than the remaining patients (27.5 ± 15.7 vs. 17.1 ± 10.3, P<0.01), while univariate linear regression analysis showed that Lown classification was independently associated with spQRS-Ta values (p=0.002, b=3.236, 95% CI 1.209-5.263).

CONCLUSIONS: SpQRS T-a could be used as a noninvasive marker of electrical instability due to cardiac involvement in patients with sarcoidosis

CLINICAL IMPLICATIONS: The clinical diagnosis of cardiac sarcoidosis is feasible with combination of electrical and structural markers with ranging sensitivity and specificity. This marker seems to be useful in identifying patients with electrical instability and possible cardiac involvement.

DISCLOSURE: The following authors have nothing to disclose: Elias Gialafos, Vasileios Kouranos, Aggeliki Rapti, Efrosyni Manali, Konstantina Aggeli, Elias Perros, Theodore Papaioannou, Petros Sfikakis, Christodoulos Stefanadis, George Tzelepis, Athol Wells, Nikolaos Koulouris

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