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Updated: Aug 11, 2025

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

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Prognostic Value of Late Gadolinium Enhancement Detected on Cardiac Magnetic Resonance in Cardiac Sarcoidosis

Alexander Stevenson1, Jonathan J H Bray2, Laura Tregidgo1

  • 1Department of Cardiology, Royal Free Hospital, London, United Kingdom.

JACC. Cardiovascular Imaging
|February 8, 2023
PubMed

Insights

Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in sarcoidosis patients significantly increases the risk of ventricular arrhythmias and mortality. Biventricular LGE may provide further prognostic insight into arrhythmogenic risk.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Immunology

Background:

  • Cardiac sarcoidosis affects approximately 5% of sarcoidosis patients, increasing risks of ventricular arrhythmias and sudden cardiac death.
  • Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is a known predictor of adverse outcomes in cardiac sarcoidosis.
  • This study systematically reviews LGE's prognostic value in patients with known or suspected cardiac sarcoidosis.

Approach:

  • A systematic review and meta-analysis of studies from Embase and MEDLINE (inception to March 2022) was conducted.
  • Included studies focused on patients with cardiac sarcoidosis undergoing CMR with LGE.
  • Outcomes assessed included all-cause mortality, ventricular arrhythmias, and a composite of both, analyzed with and without consideration of biventricular LGE.

Key Points:

  • Thirteen studies with 1,318 participants revealed that LGE on CMR is associated with significantly higher odds of ventricular arrhythmias (OR: 20.3) and all-cause mortality (OR: 3.45).
  • Biventricular LGE, invariably present with right ventricular LGE, showed a markedly increased risk of ventricular arrhythmias (OR: 43.6).
  • The presence and extent of LGE on CMR are critical prognostic indicators in cardiac sarcoidosis.

Conclusions:

  • LGE on CMR is a significant predictor of increased ventricular arrhythmias and mortality in patients with cardiac sarcoidosis.
  • Biventricular LGE offers additional prognostic information, particularly regarding arrhythmogenic risk.
  • CMR with LGE is valuable for risk stratification and prognosis in cardiac sarcoidosis.
Abstract

Keywords:
cardiac magnetic resonance (CMR)cardiac sarcoidlate gadolinium

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