ECG screening ‘reasonable’ in patients with sarcoidosis-associated uveitis
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KIAWAH ISLAND, S.C. — A study suggested that electrocardiogram screening should be performed in patients with sarcoidosis-associated uveitis because life-threatening cardiac involvement may be present even without symptoms.
“Up to 25% of deaths in sarcoidosis are related to cardiac arrhythmias or cardiac abnormalities, and there is not a lot of literature about how to detect these,” Ethan Joseph, MD, said at Kiawah Eye.
Investigators gathered data from 232 patients with sarcoidosis-associated uveitis seen at the Medical University of South Carolina Storm Eye Institute and the University of Louisville between 2005 and 2020.
Twenty patients (8.6%) had known cardiac sarcoidosis at the time of ocular diagnosis, and 45 (19%) had electrocardiogram (ECG) abnormalities that were consistent with cardiac sarcoidosis. Nine of these 45 had a known history of cardiac sarcoidosis or other cardiac comorbidities to explain the changes, while 28 of the 232 (12%) had unexplained ECG findings consistent with cardiac sarcoidosis. ECG abnormalities included bundle branch block in 33% of patients, premature ventricular contractions in 27% and ventricular conduction deficits in 16%. About 38% of patients were symptomatic from their findings, and 77% of these were treated for cardiac sarcoidosis.
The most common uveitis location was anterior, followed by posterior, panuveitis and intermediate uveitis. The most common extraocular manifestations were in the lungs and skin, followed by the heart in men and the central nervous system in women.
“We tried to find if we could predict cardiac involvement based on specific uveitis characteristics, and we couldn't find any patterns, unfortunately,” Joseph said.
However, because this preliminary study showed that ECG abnormalities are present in a subset of patients with sarcoidosis-related uveitis, “ECG would be a reasonable screening tool for patients who present with this disease,” he said.
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Joseph E. Cardiac screening and disease characteristics of patients with ocular sarcoidosis. Presented at: Kiawah Eye; May 30-June 1, 2024; Kiawah Island, South Carolina.
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