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Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis

BACKGROUND: The non-invasive diagnosis of cardiac sarcoidosis (CS) is difficult. Cardiovascular magnetic resonance (CMR) has become a very valuable diagnostic tool in patients with suspected CS, but usually a combination of different tests is used. Oxygen uptake efficiency slope (OUES) is a paramete...

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Autores principales: Ammenwerth, Wilhelm, Wurps, Henrik, Klemens, Mark A., Crolow, Catharina, Schulz-Menger, Jeanette, Schönfeld, Nicolas, Bittner, Roland C., Bauer, Torsten T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100872/
https://www.ncbi.nlm.nih.gov/pubmed/25029031
http://dx.doi.org/10.1371/journal.pone.0102333
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author Ammenwerth, Wilhelm
Wurps, Henrik
Klemens, Mark A.
Crolow, Catharina
Schulz-Menger, Jeanette
Schönfeld, Nicolas
Bittner, Roland C.
Bauer, Torsten T.
author_facet Ammenwerth, Wilhelm
Wurps, Henrik
Klemens, Mark A.
Crolow, Catharina
Schulz-Menger, Jeanette
Schönfeld, Nicolas
Bittner, Roland C.
Bauer, Torsten T.
author_sort Ammenwerth, Wilhelm
collection PubMed
description BACKGROUND: The non-invasive diagnosis of cardiac sarcoidosis (CS) is difficult. Cardiovascular magnetic resonance (CMR) has become a very valuable diagnostic tool in patients with suspected CS, but usually a combination of different tests is used. Oxygen uptake efficiency slope (OUES) is a parameter of cardiopulmonary exercise testing (CPET), which is used as an indicator for cardiovascular impairment. We investigated the predictive value of OUES for the diagnosis of myocardial involvement in sarcoid patients. METHODS: Retrospectively 37 consecutive patients (44.9±13.8 years) with histologically confirmed sarcoidosis and clinical suspicion of heart involvement underwent noninvasive diagnostic testing including CMR. CS was diagnosed according to the guidelines from the Japanese Society of Sarcoidosis and other Granulomatous Disorders with additional consideration of CMR findings. Furthermore, CPET with calculation of predicted OUES according to equations by Hollenberg et al. was carried out. RESULTS: Patients with CS (11/37; 30%) had a worse cardiovascular response to exercise. OUES was significantly lower in CS-group compared to non-CS-group (59.3±19.1 vs 88.0±15.4%pred., p<0.0001). ROC curve method identified 70%pred. as the OUES cut-off point, which maximized sensitivity and specificity for detection of CS (96% sensitivity, 82% specificity, 89% overall accuracy). OUES <70%pred. was the single best predictor of CS (Odds ratio: 100.43, 95% CI: 1.99 to 5064, p<0.001) even in multivariate analyses. CONCLUSION: OUES assessed in CPET may be helpful in identifying patient with cardiac involvement of sarcoidosis. Patient selection for CMR may be assisted by CPET findings in patients with sarcoidosis.
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spelling pubmed-41008722014-07-18 Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis Ammenwerth, Wilhelm Wurps, Henrik Klemens, Mark A. Crolow, Catharina Schulz-Menger, Jeanette Schönfeld, Nicolas Bittner, Roland C. Bauer, Torsten T. PLoS One Research Article BACKGROUND: The non-invasive diagnosis of cardiac sarcoidosis (CS) is difficult. Cardiovascular magnetic resonance (CMR) has become a very valuable diagnostic tool in patients with suspected CS, but usually a combination of different tests is used. Oxygen uptake efficiency slope (OUES) is a parameter of cardiopulmonary exercise testing (CPET), which is used as an indicator for cardiovascular impairment. We investigated the predictive value of OUES for the diagnosis of myocardial involvement in sarcoid patients. METHODS: Retrospectively 37 consecutive patients (44.9±13.8 years) with histologically confirmed sarcoidosis and clinical suspicion of heart involvement underwent noninvasive diagnostic testing including CMR. CS was diagnosed according to the guidelines from the Japanese Society of Sarcoidosis and other Granulomatous Disorders with additional consideration of CMR findings. Furthermore, CPET with calculation of predicted OUES according to equations by Hollenberg et al. was carried out. RESULTS: Patients with CS (11/37; 30%) had a worse cardiovascular response to exercise. OUES was significantly lower in CS-group compared to non-CS-group (59.3±19.1 vs 88.0±15.4%pred., p<0.0001). ROC curve method identified 70%pred. as the OUES cut-off point, which maximized sensitivity and specificity for detection of CS (96% sensitivity, 82% specificity, 89% overall accuracy). OUES <70%pred. was the single best predictor of CS (Odds ratio: 100.43, 95% CI: 1.99 to 5064, p<0.001) even in multivariate analyses. CONCLUSION: OUES assessed in CPET may be helpful in identifying patient with cardiac involvement of sarcoidosis. Patient selection for CMR may be assisted by CPET findings in patients with sarcoidosis. Public Library of Science 2014-07-16 /pmc/articles/PMC4100872/ /pubmed/25029031 http://dx.doi.org/10.1371/journal.pone.0102333 Text en © 2014 Ammenwerth et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Ammenwerth, Wilhelm
Wurps, Henrik
Klemens, Mark A.
Crolow, Catharina
Schulz-Menger, Jeanette
Schönfeld, Nicolas
Bittner, Roland C.
Bauer, Torsten T.
Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis
title Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis
title_full Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis
title_fullStr Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis
title_full_unstemmed Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis
title_short Reduced Oxygen Uptake Efficiency Slope in Patients with Cardiac Sarcoidosis
title_sort reduced oxygen uptake efficiency slope in patients with cardiac sarcoidosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100872/
https://www.ncbi.nlm.nih.gov/pubmed/25029031
http://dx.doi.org/10.1371/journal.pone.0102333
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