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Abstract Details

Cardiac Involvement In Neurosarcoidosis: A Single Center Investigation
Autoimmune Neurology
P9 - Poster Session 9 (5:30 PM-6:30 PM)
6-004
Describe the frequency of coexistent cardiac disease in a cohort of Neurosarcoidosis (NS) patients.
Sarcoidosis is a multisystem granulomatous inflammatory disease. We report the incidence of cardiac sarcoidosis in our NS cohort and examined the frequency of other cardiac diseases in the cohort.

 
Of 64 probable/definite NS patients in the University of Utah cohort, 52 patients had at least one electrocardiogram (ECG) and were included in analysis.

Of 52 NS patients with ECG, 65% were female with average age 60.9 (38-84). 58% had a BMI>30. Symptoms suggestive of cardiac dysfunction included: leg swelling (50%), palpitations (46%), chest pain (44%) and dyspnea (44%). Ten patients (19%) had at least one myocardial infarction confirmed by cardiology.  ECG abnormalities included non-specific T wave change (40%), right bundle branch block (RBBB) (19%), AV block (16%), and QT prolongation (12%). 10 patients had sinus tachycardia, 5 had sinus bradycardia, and 1 each had ventricular tachycardia (VT) and non-sustained VT. Six patients required implantable cardioverter-defibrillator placement and one required a pacemaker.

Cardiac MRI on 17 patients (33%) revealed 3 (17%) with diffuse myocardial enhancement possibly suggesting cardiac sarcoidosis (CS). All had leg swelling, plus one each with orthopnea, syncope, or dyspnea. Myocardial PET scan was performed on 9 NS patients, confirming 3 known CS, and revealing one newly diagnosed CS, who had leg swelling and dyspnea.  2 additional patients had ICD placement after detection of high-grade AV block and persistent atrial fibrillation, respectively, but no evidence of CS on cardiac MRI. Of 6 confirmed CS patients, 3 patients manifested initially as NS.
Of 52 NS patients, 12% had cardiologist-confirmed CS. Non-sarcoid cardiac illness was also common, emphasizing the need for comprehensive cardiac evaluation in NS. Research is needed to determine if sarcoid-related morbidity may contribute to increased all-cause cardiac disease.
Authors/Disclosures
Sama Noroozi Gilandehi, MD
PRESENTER 		Dr. Noroozi Gilandehi has nothing to disclose.
Ka-Ho Wong (U of U Neurology Clinic) The institution of Mr. Wong has received research support from The Sumaira Foundation . The institution of Mr. Wong has received research support from The Siegel Rare Neuroimmune Association.
Melissa A. Wright, MD (University of Utah) Dr. Wright has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis .
Jennifer Lord, MD (Novant Health) Dr. Lord has nothing to disclose.
No disclosure on file
No disclosure on file
Stacey Clardy, MD, PhD, FAAN (University of Utah) Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Beaumont Health, CCF, Emory, Penn State, Mayo Clinic, Walter Reed.