📄 LGE phenotype vs burden in cardiac sarcoidosis: does pattern matter more than quantity? 🔗 DOI: doi.org/10.1093/ehjimp/qyag0… 🫀 In cardiac sarcoidosis, risk stratification for ventricular arrhythmias remains challenging. This prospective study compares LGE burden vs LGE phenotype on CMR for predicting arrhythmic events. ✨ Key findings: 🔹 The “pathology-frequent” LGE phenotype strongly predicts ventricular arrhythmias ➡️ All arrhythmic events occurred only in this phenotype 🔹 Both approaches perform well: LGE burden (quantitative %) LGE phenotype (pattern-based) 👉 BUT: 🔹 LGE phenotype achieved 100% negative predictive value ➡️ No events in patients without this phenotype ⚡ Practical advantages of LGE phenotyping: ✅ Much higher reproducibility (κ = 0.97 vs 0.41) ✅ ~5x faster than LGE quantification ✅ Easier to apply in clinical routine 📊 Additional insights: 👉 Arrhythmic risk is mainly linked to scar-related re-entry, not inflammation 👉 FDG-PET did not add independent prognostic value 💡 Clinical take-home message: 👉 Pattern recognition may be as important as quantification 👉 LGE phenotype could: improve risk stratification guide ICD decision-making simplify clinical workflows 🚨 Bottom line: In cardiac sarcoidosis, how scar looks may matter more than how much scar there is. #Cardiology #CardiacSarcoidosis #CMR #LGE #Arrhythmia #SuddenCardiacDeath #Imaging #RiskStratification #Electrophysiology 🫀⚡📊