Early Screening using Enhanced ECG analysis for Cardiac Sarcoidosis in Adults with known Extra-cardiac Sarcoidosis.

This study is an observational diagnostic accuracy investigation evaluating the utility of enhanced electrocardiogram (ECG) analysis for detecting cardiac involvement in individuals with established extra-cardiac sarcoidosis. All participants will attend a single study visit during which they will undergo a standardised clinical assessment. The overall duration of the clinic visit will be up to 3 hours. This visit includes: (1) Clinical review & physical assessment - 15 minutes (2) Routine 12-lead ECG - 15 minutes (3) Blood sampling for both routine cardiac biomarkers and exploratory inflammatory markers - 15 minutes (3) Completion of validated health questionnaires (SF-36, King's Sarcoidosis Questionnaire) - 30 minutes (4) Cardiac magnetic resonance (CMR) scan, which serves as the reference standard for determining cardiac involvement - 1 hour Enhanced ECG analysis will be performed offline using established computational platforms, including Advanced-ECG and the GE Healthcare Marquette 12SL algorithm. These analyses will be applied to the digital ECG files obtained during the study visit and will not require any additional testing or participant involvement. Enhanced ECG-derived electrical parameters will subsequently be compared with CMR findings to determine their diagnostic performance in identifying early or subclinical cardiac involvement. All participants will undergo a comprehensive CMR scan that includes standard clinical sequences as well as research-specific sequences. Imaging will be reviewed by trained cardiologists and further processed using externally validated computational tools developed by the Auckland Bioengineering Institute. Overall, this multimodality observational pilot study integrates clinical data, ECG analysis, blood biomarkers, and advanced CMR imaging to assess whether enhanced ECG analysis can improve early detection and screening strategies for cardiac sarcoidosis.

This study will evaluate the utility of enhanced electrocardiogram (ECG) analysis for detecting cardiac involvement in individuals with established extra-cardiac sarcoidosis. All participants will attend a single study visit during which they will undergo a standardised clinical assessment. The overall duration of the clinic visit will be up to 3 hours. This visit includes: (1) Clinical review & physical assessment - 15 minutes (2) Routine 12-lead ECG - 15 minutes (3) Blood sampling for both routine cardiac biomarkers and exploratory inflammatory markers - 15 minutes (3) Completion of validated health questionnaires (SF-36, King's Sarcoidosis Questionnaire) - 30 minutes (4) Cardiac magnetic resonance (CMR) scan, which serves as the reference standard for determining cardiac involvement - 1 hour Enhanced ECG analysis will be performed offline using established computational platforms, including Advanced-ECG and the GE Healthcare Marquette 12SL algorithm. These analyses will be applied to the digital ECG files obtained during the study visit and will not require any additional testing or participant involvement. These E-ECG–derived indices will be compared with cardiac MRI findings, including the presence or absence of LGE and extracellular volume, to assess their relationship with subclinical cardiac involvement. This is a multivariable model development study of E-ECG parameters that can identify CMR defined subclinical cardiac involvement. All participants will undergo a comprehensive CMR scan that includes standard clinical sequences as well as research-specific sequences. Imaging will be reviewed by trained cardiologists and further processed using externally validated computational tools developed by the Auckland Bioengineering Institute. Overall, this multimodality observational study integrates clinical data, ECG analysis, blood biomarkers, and advanced CMR imaging to assess whether enhanced ECG analysis can improve early detection and screening strategies for cardiac sarcoidosis.