{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:21:37Z","timestamp":1760746897067,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cardiac involvement, one of the most life-threatening complications of sarcoidosis, remains under-recognized due to its oligo-symptomatic presentation in some patients. This retrospective study aimed to evaluate the utility of various clinical predictors of cardiac sarcoidosis (CS) development. Methods: The study included patients with pulmonary sarcoidosis diagnosed according to the recent ATS guidelines between January 2020 and July 2024 who underwent cardiac magnetic resonance (CMR) due to clinical suspicion of CS. The original Lake Louise criteria were used to identify active myocarditis. Results: Out of 393 patients diagnosed with pulmonary sarcoidosis, CMR was performed in 92 patients. Cardiac sarcoidosis was confirmed in 48 patients (52%, CS+), and excluded in 44 patients (48%, CS\u2212). CS(+) patients demonstrated significantly more frequent Holter ECG abnormalities and liver\/spleen sarcoidosis compared to CS(\u2212) patients. Stage IV pulmonary disease, ECG abnormalities, and hypercalcemia were more common in CS(+) than in CS(\u2212) patients; however, these differences did not reach statistical significance. Multivariate analysis identified Holter ECG abnormalities and liver\/spleen involvement as significant predictive factors for CS, increasing the risk of cardiac involvement by approximately 4- and 6-fold, respectively. An AI-assisted simple scoring system based on five parameters: ECG abnormalities, Holter ECG abnormalities, liver\/spleen involvement, gender, and stage of sarcoidosis predicted CS with a sensitivity of 76% and specificity of 74%, using an optimal cut-off value of \u22657.6 points. Conclusions: In patients with pulmonary sarcoidosis, an AI-assisted scoring algorithm derived from L1-regularized logistic regression results accurately predicted cardiac involvement on CMR with high specificity and sensitivity. Prospective validation of this algorithm is necessary to confirm its clinical utility in predicting cardiac sarcoidosis.<\/jats:p>","DOI":"10.3390\/jcm14207290","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T11:39:34Z","timestamp":1760701174000},"page":"7290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["AI-Assisted Simple Scoring Algorithm Was Helpful in the Risk Assessment of Cardiac Involvement in Patients with Pulmonary Sarcoidosis"],"prefix":"10.3390","volume":"14","author":[{"given":"Malgorzata","family":"Dybowska","sequence":"first","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Witold Z.","family":"Tomkowski","sequence":"additional","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4648-2864","authenticated-orcid":false,"given":"Katarzyna B.","family":"Lewandowska","sequence":"additional","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"Piotrowska-Kownacka","sequence":"additional","affiliation":[{"name":"1st Department of Radiology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9311-9753","authenticated-orcid":false,"given":"Malgorzata","family":"Sobiecka","sequence":"additional","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1546-7968","authenticated-orcid":false,"given":"Anna","family":"Kempisty","sequence":"additional","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucyna","family":"Opoka","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Research Institute of Tuberculosis and Lung Diseases, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Radwan-Rohrenschef","sequence":"additional","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3973-1310","authenticated-orcid":false,"given":"Dorota","family":"Wyrostkiewicz","sequence":"additional","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Szturmowicz","sequence":"additional","affiliation":[{"name":"1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1700991","DOI":"10.1183\/13993003.00991-2017","article-title":"Phenotypes of organ involvement in sarcoidosis","volume":"5","author":"Schupp","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"321","DOI":"10.31083\/j.rcm.2020.03.102","article-title":"Cardiac sarcoidosis: Diagnosis and management","volume":"1","author":"Markatis","year":"2020","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1164\/ajrccm.164.10.2104046","article-title":"Case Control Etiologic Study of Sarcoidosis (ACCESS) research group. Clinical characteristics of patients in a case control study of sarcoidosis","volume":"164","author":"Baughman","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"B\u0142asi\u0144ska, K., J\u0119drych, M.E., Opoka, L., Tomkowski, W., and Szturmowicz, M. (2023). Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis. Biomedicines, 11.","DOI":"10.3390\/biomedicines11071866"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zimna, K., Szturmowicz, M., Sobiecka, M., B\u0142asi\u0144ska, K., Bartosiewicz, M., and Tomkowski, W.Z. (2023). Sudden Vision Loss Due to Optic Neuritis-An Uncommon Presentation of Neurosarcoidosis. Diagnostics, 13.","DOI":"10.3390\/diagnostics13152579"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/joim.13629","article-title":"Sarcoidosis: Epidemiology and clinical insights","volume":"293","author":"Rossides","year":"2023","journal-title":"J. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.amjcard.2023.07.123","article-title":"Cardiac Sarcoidosis: Updated Insights on Epidemiology and Diagnostic Criteria","volume":"204","author":"Santulli","year":"2023","journal-title":"Am. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1136\/heartjnl-2019-316442","article-title":"Cardiac sarcoidosis: State-of-the-art review","volume":"107","author":"Kouranos","year":"2021","journal-title":"Heart"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.tcm.2022.06.012","article-title":"Editorial commentary: Cardiac sarcoidosis in contemporary practice: Forward progress, but clinical quandaries persist","volume":"33","author":"Zipse","year":"2023","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1161\/CIRCULATIONAHA.121.058120","article-title":"Incidence of Sudden Cardiac Death and Life-Threatening Arrhythmias in Clinically Manifest Cardiac Sarcoidosis With and Without Current Indications for an Implantable Cardioverter Defibrillator","volume":"146","author":"Nordenswan","year":"2022","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1111\/echo.13281","article-title":"Improved detection of myocardial damage in sarcoidosis using longitudinal strain in patients with preserved left ventricular ejection fraction","volume":"33","author":"Murtagh","year":"2016","journal-title":"Echocardiography"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1161\/CIRCULATIONAHA.109.851352","article-title":"Detection of myocardial damage in patients with sarcoidosis","volume":"120","author":"Patel","year":"2009","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1161\/01.CIR.58.6.1204","article-title":"Cardiac sarcoid: A clinicopathologic study of 84 unselected patients with systemic sarcoidosis","volume":"58","author":"Silverman","year":"1978","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1164\/rccm.202002-0251ST","article-title":"Diagnosis and Detection of Sarcoidosis. An Official American Thoracic Society Clinical Practice Guideline","volume":"201","author":"Crouser","year":"2020","journal-title":"Am. J. Respir. Crit. Care. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1136\/thoraxjnl-2019-214348","article-title":"BTS Clinical Statement on pulmonary sarcoidosis","volume":"76","author":"Thillai","year":"2021","journal-title":"Thorax"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.jacc.2009.02.007","article-title":"Cardiovascular magnetic resonance in myocarditis: A JACC White Paper","volume":"53","author":"Friedrich","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"106331","DOI":"10.1016\/j.rmed.2021.106331","article-title":"Optimizing routine screening for cardiac sarcoidosis through use of commonly available studies","volume":"178","author":"Holtzclaw","year":"2021","journal-title":"Respir. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/j.hrthm.2014.03.043","article-title":"HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis","volume":"11","author":"Birnie","year":"2014","journal-title":"Heart Rhythm."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1197","DOI":"10.1161\/CIR.0000000000001240","article-title":"Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement from the American Heart Association","volume":"149","author":"Cheng","year":"2024","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"2023 ESC Guidelines for the management of cardiomyopathies","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2697","DOI":"10.1093\/eurheartj\/ehae356","article-title":"Management of cardiac sarcoidosis","volume":"45","author":"Sharma","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"107954","DOI":"10.1016\/j.rmed.2025.107954","article-title":"Prevalence, incidence, and clinical features of cardiac involvement in patients with pulmonary sarcoidosis","volume":"238","author":"Nakamura","year":"2025","journal-title":"Respir. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s00408-024-00772-5","article-title":"Holter Monitoring and Cardiac Biomarkers in Screening for Cardiac Sarcoidosis","volume":"203","author":"Bakker","year":"2024","journal-title":"Lung"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00408-015-9805-8","article-title":"Cardiac Sarcoidosis: Is it More Common in Men?","volume":"194","author":"Boros","year":"2016","journal-title":"Lung"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1253\/circj.CJ-19-0508","article-title":"Japanese Circulation Society Joint Working Group. JCS 2016 Guideline on Diagnosis and Treatment of Cardiac Sarcoidosis. Digest Version","volume":"83","author":"Terasaki","year":"2019","journal-title":"Circ. J."},{"key":"ref_26","first-page":"341","article-title":"Update in Cardiac Sarcoidosis","volume":"16","author":"Jellis","year":"2019","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_27","first-page":"11","article-title":"Diagnostic approach for cardiac involvement in sarcoidosis","volume":"36","author":"Darlington","year":"2019","journal-title":"Sarcoidosis Vasc. Diffuse Lung Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1378\/chest.106.4.1021","article-title":"Holter monitoring as a non-invasive indicator of cardiac involvement in sarcoidosis","volume":"106","author":"Suzuki","year":"1994","journal-title":"Chest"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.amjcard.2013.03.027","article-title":"Predictors of cardiac sarcoidosis using commonly available cardiac studies","volume":"112","author":"Freeman","year":"2013","journal-title":"Am. J. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e000608","DOI":"10.1136\/bmjresp-2020-000608","article-title":"CASPA (CArdiac Sarcoidosis in PApworth) improving the diagnosis of cardiac involvement in patients with pulmonary sarcoidosis: Protocol for a prospective observational cohort study","volume":"7","author":"Williams","year":"2020","journal-title":"BMJ Open Respir. Res."},{"key":"ref_31","first-page":"298","article-title":"A joint procedural position statement on imaging in cardiac sarcoidosis: From the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology","volume":"25","author":"Slart","year":"2018","journal-title":"J. Nucl. Cardiol. Off. Publ. Am. Soc. Nucl. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1007\/s11886-018-1065-9","article-title":"Echocardiography in Sarcoidosis","volume":"20","author":"Kurmann","year":"2018","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1164\/rccm.201010-1679OC","article-title":"Sarcoidosis-related mortality in the United States from 1988 to 2007","volume":"183","author":"Swigris","year":"2011","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1111\/echo.14886","article-title":"Speckle tracking echocardiography can predict subclinical myocardial involvement in patients with sarcoidosis: A meta-analysis","volume":"37","author":"Barssoum","year":"2020","journal-title":"Echocardiography"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Di Stefano, C., Bruno, G., Arciniegas Calle, M.C., Acharya, G.A., Fussner, L.M., Ungprasert, P., Cooper, L.T., Blauwet, L.A., Ryu, J.H., and Pellikka, P.A. (2020). Diagnostic and predictive value of speckle tracking echocardiography in cardiac sarcoidosis. BMC Cardiovasc. Disord., 20.","DOI":"10.1186\/s12872-019-01323-0"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3158","DOI":"10.1016\/j.jacc.2018.09.072","article-title":"Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations","volume":"72","author":"Ferreira","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s12968-017-0389-8","article-title":"Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI)","volume":"19","author":"Messroghli","year":"2017","journal-title":"J. Cardiovasc. Magn. Reson."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/20\/7290\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T12:12:35Z","timestamp":1760703155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/20\/7290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,15]]},"references-count":37,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14207290"],"URL":"https:\/\/doi.org\/10.3390\/jcm14207290","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,15]]}}}