Significant Prevalence of Left Ventricular Diastolic Dysfunction in Patients with Sarcoidosis

Background: Sarcoid heart disease is a rare concern. The aim of the study was to evaluate the cardiac involvement, determine the prevalence of left ventricular diastolic dysfunction and find out the relation with other findings in patients with pulmonary sarcoidosis.

Methods: Thirty consecutive inpatients with pulmonary sarcoidosis were underwent 2-D, M-mode and doppler echocardiography. All patients were assessed clinically and 12-lead electrocardiography, serum angiotensin converting enzyme levels, thorax computed tomography, pulmonary func­tion tests, arterial blood gas levels, carbon monoxide diffusion capacity, bronchoalveolar lavage were ordered. Patients were divided into two gro­ups; with diastolic dysfunction (A) or without diastolic dysfunction (B).

Results: Left ventricular diastolic dysfunction was detected in 19 (63.3%) patients. In comparison of the diastolic indexes, it was disclosed that the­re were significant prolonged isovolumic relaxation time, deceleration ra­te of early diastolic flow values and, reversal of E/A ratio in group A. The­re was statistically significant difference for Pa02 level between two gro­ups (p=0.029). Low Pa02 levels were observed in seven patients (36.8%) with diastolic dysfunction, where Pa02 levels were normal in all patients without diastolic dysfunction. Low forced vital capacity (p=0.023) and much more symptoms like dyspnea and nonspecific chest pain (p=0.026) were detected in patients with diastolic dysfunction. There were no diffe­rences when the patients in group A and group B were compared regar­ding the clinical, radiological, laboratory characteristics.

Conclusion: There is a significant prevalence of abnormal left ventricular diastolic dysfunction in patients with sarcoidosis even if there was no cli­nical suspicion of cardiac involvement.