@misc{oai:repo.qst.go.jp:00067033,
 author = {Ohira, Hiroshi and Yoshinaga, Keiichiro and Sakiyama, Shinya and Nakata, Toshitaka and Suzuki, Naoko and Sugimoto, Ayako and Hayashishita, Akiko and Manabe, Osamu and Oyama-Manabe, Noriko and Watanabe, Taku and Tsujino, Ichizo and Nishimura, Masaharu and 吉永 恵一郎},
 month = {Sep},
 note = {Background: Heart Rhythm Society (HRS) consensus statement recommends that patients with biopsy-proven extracardiac sarcoidosis (extra-CS) should be screened for CS with a 12-lead electrocardiogram (ECG) and echocardiogram. However, there are lack of studies investigating prevalence of CS in patients with normal ECG and echocardiogram. We sought to investigate prevalence and explore characteristics among these patient cohorts. 
Methods: We studied 94 consecutive biopsy proven extra-CS patients. All patients underwent FDG-PET and cardiac MRI for the evaluation of CS. Patients were categorized in 2 groups according to the results of ECG and echocardiogram as normal or either (abnormal ECG or echocardiogram). The Japanese Ministry of Health and Welfare (JMHW) criteria 2015 were used as the standard for the diagnosis of CS. 
Results: Among the 94 patients (age 54+/-17 years, 66% females), 28 (30%) were normal and 66 (70%) were either group. The prevalence of CS was as follows; 6/28 (21%) for normal, 39/66 (59%) for either (p=0.0006). Of these 6 patients, FDG-PET and/or cardiac MRI indicated that 1 patient had multiple organ involvement (lung, skin, stomach, bone and heart), 3 patients had cardiac involvement in the RV papillary muscle, inferior or lateral wall of the LV, 1 patient had small subendocardial lesions in the mid segments of the anteroseptal and inferior walls, and 1 had relatively lower LVEF for his age.
Conclusions: The prevalence of CS exceeds 20% even in extra-CS patients with normal ECG and echocardiogram. Physicians should keep in mind in such population., The 28th ERS International Congress},
 title = {Risk of Underdiagnosis of Cardiac Sarcoidosis by Routine Electrocardiogram and Echocardiogram in Patients with Biopsy-proven Extracardiac Sarcoidosis},
 year = {2018}
}