Long-term results obtained by cardiovascular magnetic resonance imaging and somatostatin receptor PET in cardiac sarcoidosis

Cardiac affection constitutes a major limiting condition in systemic sarcoidosis.We performed cardiovascular magnetic resonance (CMR) imaging and somatostatin receptor scintigraphy to define the course in cardiac sarcoidosis (CS).In a pilot study, we identified cardiac involvement – diagnosed by CMR imaging – to be present in 29 of 188 patients (15.4%) with histologically proven, extracardiac sarcoidosis. Out of these initial 29 CS-positive patients, 27 patients (49.9 ± 11.8 years, 59.3% male) were presently re-examined and underwent a second CMR-study. 68Ga-DOTATOC PET/CT was performed when clinically indicated (17 patients).Within a median follow-up period of 2.6 years, none of the initial 29 patients deceased or experienced aborted sudden cardiac death. Among the 27 re-examined cardiac sarcoidosis patients, pathological CMR-findings persisted in 14 of 27 patients (51.9%): 7 patients (25.9% of total study population) exhibited myocardial scar; 1 patient (3.7%) showed increased relative gadolinium enhancement as well as myocardial oedema, as markers of acute inflammatory injury. Both acute and chronic phase cardiac involvement was present in 6 patients (22.2%). Standard CS evaluation parameters as well as laboratory testing failed to recognize CS-persistence.68Ga-DOTATOC PET/CT identified 2 patients with regions of raised tracer uptake that concorded with acute inflammatory changes, as assessed by CMR.Cardiac sarcoid affection persisted in barely half the ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 1.3 Imaging Source Type: research