Abstract 14529: Characteristics of Patients with Cardiac Sarcoidosis Presenting Primarily with Ventricular Arrhythmias

Background: Cardiac involvement is an important prognostic factor of sarcoidosis and ventricular tachycardia (VT) is a common presentation of patients with cardiac sarcoidosis (CS). In this study, we aimed to elucidate the predictors of developing such serious arrhythmias in CS patients. Methods: We examined 61 consecutive patients with CS who were admitted to our Hospital from January 2004 until March 2011. The diagnosis of CS was made based on the guidelines by the Japanese Ministry of Health and Welfare. We analyzed various demographic and clinical data, including delayed enhancement on cardiac magnetic resonance imaging (DE-MRI), with a special reference to their association with ventricular arrhythmias as a primary presentation of CS. Results: The CS patients were mostly middle-aged (58±12 years), females (62%) and mostly with grossly normal heart structure (60%), with a dilated cardiomyopathy-like phenotype as the only observed structural abnormality (40%) and ventricular arrhythmias as the most encountered electrical abnormality (47%). Of the parameters studied, no significant association with a primary presentation of ventricular arrhythmias was noted for age, gender or the presence of extra-cardiac sarcoidosis (P=0.63, 0.42 and 0.58 respectively). In contrast, a significant association with a primary presentation of ventricular arrhythmias was noted for compromised LV function at admission, including a worse NYHA class (P=0.041) and a lower LVEF (P=0.007). Importantly, the presence of DE-MRI was the most significant parameter associated with ventricular arrhythmia presentation (P=0.047, r =0.426) and the absence of DE-MRI carried a 100% negative predictive value for this presentation. Conclusions: These results indicate that compromised LV function and more importantly, DE-MRI, are significant clinical characteristics associated with ventricular arrhythmias as a primary presentation of CS.