VentriPoint Diagnostics Ltd (VPTDF)

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Sarcoidosis: Current Concepts, Research Imperative

Additional sarcoidosis experts from 4 major institutions that could be targeted by VPT's sales/marketing team as they're all using MRI for the moment.

High-Risk Sarcoidosis. Current Concepts and Research Imperatives (2017)

William H. Sauer1, Barney J. Stern 2*, Robert P. Baughman 3, Daniel A. Culver 4, and Walter Royal 2

-Author Affiliations:

Corresponding Author: William H. Sauer


1University of Colorado School of Medicine, Denver, Colorado

2University of Maryland School of Medicine, Baltimore, Maryland

3University of Cincinnati School of Medicine, Cincinnati, Ohio; and

4Cleveland Clinic Foundation, Cleveland, Ohio


Dec 01, 2017

https://doi.org/10.1513/AnnalsATS.201707-566OT PubMed: 29073361

Pulmonary Hypertension

Sarcoidosis-associated pulmonary hypertension has a reported prevalence of 5 to 10% among all patients with sarcoidosis (21), but the prevalence exceeds 50% in patients with persistent dyspnea (22, 23) and in cases severe enough to warrant lung transplantation (24). The detection of pulmonary hypertension in sarcoidosis is often elusive because of the nonspecific presenting symptoms (e.g., exertional dyspnea). Although transthoracic echocardiography may be a useful screening tool, it is inaccurate in many patients with sarcoidosis-associated pulmonary hypertension (25, 26), and other factors, including exertional hypoxemia, may be used to screen for this entity (21). Table 2 lists some of the features that have been associated with the presence of pulmonary hypertension in patients with pulmonary sarcoidosis, but it requires further validation. Some of the features, such as persistent dyspnea, reduced DlCO, and reduced 6-minute-walk distance, may be due to underlying lung disease. However, it has been found that the presence of these features is more common in patients with sarcoidosis with pulmonary hypertension and should warrant further consideration. The definitive test is the right heart catheterization, which should be considered in patients with sarcoidosis with one or more of the features listed in the table. Other objective methods to detect sarcoidosis-associated pulmonary hypertension include determining the ratio of the diameter of the main pulmonary artery to aorta (27). Cardiac magnetic resonance imaging (MRI) may also provide insight into right ventricular function. Although these noninvasive approaches are effective for screening, it is often necessary to perform invasive hemodynamic monitoring to accurately characterize pulmonary hypertension associated with sarcoidosis to guide therapeutic interventions. Future studies may obviate the need for invasive monitoring by better establishing the correlations between noninvasive techniques (e.g., transthoracic echocardiography and cardiac MRI) and through the further development of emerging imaging technology (e.g., myocardial strain detection) (28).