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Speckle Tracking Echocardiography Can Predict Subclinical Myocardial Involvement in Patients with Sarcoidosis: A Meta-Analysis
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  • Kirolos Barssoum,
  • Ahmed Altibi,
  • Devesh Rai,
  • Ashish Kumar,
  • Adnan Kharsa,
  • Medhat Chowdhury,
  • Sara Shahid,
  • Mohamed Abdelazeem,
  • Ahmed Abuzaid,
  • Qiu Tong,
  • Bipul Baibhav,
  • Scott Feitell,
  • Mallory Balmer-Swain,
  • Mohan Rao,
  • Myriam Amsallem,
  • Navin C. Nanda
Kirolos Barssoum
Rochester Regional Health System
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Ahmed Altibi
Henry Ford Allegiance Health
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Devesh Rai
Rochester City School District
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Ashish Kumar
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Adnan Kharsa
Rochester General Hospital
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Medhat Chowdhury
Rochester General Hospital
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Sara Shahid
Rochester Regional Health System
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Mohamed Abdelazeem
St. Elizabeth Medical Center
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Ahmed Abuzaid
University of California San Francisco
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Qiu Tong
Rochester Regional Health
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Bipul Baibhav
Rochester Regional Health
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Scott Feitell
Rochester Regional Health
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Mallory Balmer-Swain
Rochester General Hospital
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Mohan Rao
Rochester Regional Health
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Myriam Amsallem
Stanford Univ
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Navin C. Nanda
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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.

Peer review status:ACCEPTED

03 Aug 2020Submitted to Echocardiography
03 Aug 2020Submission Checks Completed
03 Aug 2020Assigned to Editor
09 Aug 2020Reviewer(s) Assigned
06 Sep 2020Review(s) Completed, Editorial Evaluation Pending
06 Sep 2020Editorial Decision: Revise Minor
08 Sep 20201st Revision Received
09 Sep 2020Submission Checks Completed
09 Sep 2020Assigned to Editor
09 Sep 2020Reviewer(s) Assigned
19 Sep 2020Review(s) Completed, Editorial Evaluation Pending
20 Sep 2020Editorial Decision: Accept