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Screening for cardiac involvement in patients with sarcoidosis using AIIMS algorithm

Devesh Kumar1, Karan Madan2, Priya Jagia3

  • 1Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, Room No. 20, 7th Foor, New Delhi, 110029, India.

The International Journal of Cardiovascular Imaging
|May 30, 2025
PubMed

Insights

The AIIMS screening algorithm, incorporating global longitudinal strain and biomarkers, significantly improves cardiac sarcoidosis detection compared to the standard HRS algorithm. This enhanced approach aids earlier diagnosis and potentially better patient outcomes.

Area of Science:

  • Cardiology
  • Immunology
  • Medical Imaging

Background:

  • Cardiac involvement in sarcoidosis negatively impacts patient prognosis.
  • Early detection and treatment are crucial for improving outcomes in cardiac sarcoidosis.
  • Current diagnostic algorithms, like the Heart Rhythm Society (HRS) screening algorithm, rely on symptoms, ECG, and conventional echocardiography.

Purpose of the Study:

  • To evaluate the efficacy of the AIIMS screening algorithm, which adds global longitudinal strain (GLS) and cardiac biomarkers (Troponin, NT-Pro-BNP) to the HRS criteria.
  • To determine if the AIIMS algorithm improves the detection rate of cardiac involvement in patients with sarcoidosis.

Main Methods:

  • A cohort of 100 patients with biopsy-proven sarcoidosis was screened.
  • Screening included assessment of cardiac symptoms, ECG, conventional echocardiography, GLS, Troponin I, and NT-Pro-BNP.
  • Patients positive on screening underwent advanced imaging (cardiac MRI or radionuclide imaging) for confirmation.

Main Results:

  • The AIIMS algorithm identified cardiac involvement in 32% of patients, a 30% increase over the HRS algorithm (24%).
  • Abnormal GLS was detected in 32% of patients.
  • Biomarkers showed elevated Troponin I in 16% and NT-Pro-BNP in 19% of patients.

Conclusions:

  • The AIIMS screening algorithm demonstrates superior detection of cardiac involvement in sarcoidosis patients.
  • Integrating GLS and biomarkers enhances diagnostic yield, potentially leading to earlier intervention.
  • Further validation in larger studies is recommended for the AIIMS algorithm.

Keywords:
Cardiac sarcoidosisMagnetic resonance imagingScreening

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