DOPPLER-ECHOCARDIOGRAPHIC DETECTION OF LEFT-VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH PULMONARY SARCOIDOSIS

Study objective: To determine the prevalence of left ventricular diast olic dysfunction in patients with biopsy specimen-proved pulmonary sar coidosis without clinical evidence of cardiac disease. Design: A cross -sectional study. Setting: A large tertiary care university teaching h ospital, Patients and control subjects: Fifty consecutive subjects had biopsy specimen-proved pulmonary sarcoidosis without suspected cardia c involvement, Those with other conditions known to affect diastolic f unction were excluded, The control group comprised 30 healthy hospital workers. Interventions: Clinical examination, 12-lead EGG, and combin ed echocardiographic/phonocardiographic examination. Measurements: Ind exes of left ventricular diastolic function, including isovolumic rela xation time, peak velocity of early (E) and late (A) ventricular filli ng, deceleration rate of early diastolic flow, and the sum of the time velocity integrals of E and A were obtained in each patient and contr ol subject, Systolic function was determined using a modification of S impson's rule, Results: Diastolic dysfunction was present in 7 (14%) p atients, 6 of whom had normal systolic function and normal two-dimensi onal echocardiographic examination. Those with diastolic dysfunction h ad a longer duration of illness (15+/-7 vs 6+/-5 years; p=0.0004), wer e significantly older (52+/-11 vs 38+/-9 years; p=0.0009), and had hig her systolic BP (130+/-13 vs 117+/-12 mm Hg; p=0.01) than the sarcoid patients with normal diastolic function. Conclusions: These results de monstrate a significant prevalence of left ventricular diastolic dysfu nction in patients with pulmonary sarcoidosis. The cause of this abnor mality may be a subclinical sarcoid cardiomyopathy.