Utility of N-13 Ammonia and F-18 Fluorodeoxyglucose Cardiac Positron Emission Tomography in Assessing Regional Prevalence of Cardiac Sarcoidosis

1575Background: Sarcoidosis is a multisystem disease of unknown etiology. The prevalence of clinically evident cardiac involvement is about 5%, though this may be an underestimation given the difficulties of diagnosing cardiac sarcoidosis (CS). Only 40% of patients with CS diagnosed at autopsy have the diagnosis made during their lifetime. Cardiac PET is an excellent tool for diagnosis and follow up of CS patients. Little is known of the regional myocardial involvement of CS. In the current series, we utilize PET to determine the most commonly sarcoid-afflicted myocardium regions. Methods: 45 patients (mean age 54 +/- 8.4, 69% male) had studies positive for CS with N-13 NH3/FDG PET/CT (N=99 total scans). Patients adhered to a standardized protocol, undergoing a 24 hour fast from carbohydrates, plus unfractionated heparin intravenously (10-50IU/kg) 15 minutes prior to FDG injection. Scans were obtained 90 minutes after FDG injection. All patients underwent rest N-13 NH3 perfusion imaging prior to administering FDG. Perfusion-metabolism mismatch defects and mean SUV for involved segments in the 17 segment model were determined using INVIA 4DM software. Presence of sarcoid was determined using the perfusion-metabolism mismatch defect criteria. Percentage of cardiac sarcoidosis was calculated per segment (1-17 individually), and per segment group [basal region (segments 1-6), middle region (segments 7-12), and distal region (segments 13-17)]. Results: Of the sarcoid-positive scan...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Poster Session Source Type: research

Related Links:

This article focuses on the role of echocardiography and MRI in the diagnosis of these structural diseases. Cardiomyopathies with hypertrophic pattern (hypertrophic cardiomyopathy, restrictive cardiomyopathies, amyloidosis, Anderson-Fabry disease, and sarcoidosis), cardiomyopathies with dilated pattern, inflammatory cardiac diseases, and right ventricular arrhythmogenic cardiomyopathy are analyzed. Finally, anatomic predictors of arrhythmias and sudden cardiac death are discussed. Each paragraph is attended by clinical cases that are discussed on the electrocardiogram, after integrated with the anatomic, functional, and he...
Source: Cardiac Electrophysiology Clinics - Category: Cardiology Source Type: research
Conclusion: In patients not meeting clinical criteria for CS and without extra-cardiac sarcoidosis, the overall event rate was similar between patients with and without abnormal FDG uptake. The overall low event rate suggests a potential lack of clinical utility in obtaining FDG PET imaging for all patients with non-ischemic cardiomyopathy to evaluate for CS. Future investigations are needed to determine if FDG PET imaging may be better targeted to certain subgroups of patients with non-ischemic cardiomyopathy.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Poster Session Source Type: research
Conclusions: The classification performance of DCNN-based features outperformed the CoV-based classification performance. Experimental results suggested that DCNN-based high-dimensional features have a potential of semi-automated diagnosis of CS.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Deep Learning In Molecular Imaging Studies Source Type: research
Authors: Iwazaki K, Kojima T, Murasawa T, Yokota J, Tanimoto H, Matsuda J, Fukuma N, Matsubara T, Shimizu Y, Oguri G, Hasumi E, Kubo H, Chang K, Fujiu K, Komuro I Abstract A cardiac resynchronization therapy defibrillator (CRT-D) (Medtronic Inc. Protecta XT) was implanted in a 67-year-old man who had cardiac sarcoidosis with extremely low cardiac function. He had ventricular tachycardia which was controlled by catheter ablation, medication and pacing. The programmed mode was DDI, lower rate was 90 beats/minute, paced AV delay was 150 ms, and the noncompetitive atrial pacing (NCAP) function was programmed as 300 ms....
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Predominant or isolated right ventricular involvement in cardiac sarcoidosis is uncommon, but should always be considered in a case of right ventricular hypertrophy combined with ventricular arrhythmia and/or conduction disturbance. Although improvement in right ventricular hypertrophy and atrioventricular conduction disturbance following corticosteroid therapy has been reported, the detailed serial electrocardiographic responses during corticosteroid therapy, as well as temporal changes in the electrocardiographic, biochemical, and morphological responses, have not been reported.
Source: Journal of Electrocardiology - Category: Cardiology Authors: Source Type: research
Authors: Ghanizada M, Rossing K, Bundgaard H, Gustafsson F Abstract INTRODUCTION: The course and prognosis of cardiac sarcoidosis (CS) are sparsely described. The purpose of this study was to assess the clinical presentation, treatment response and prognosis for patients with CS. METHODS: This was a single-centre retrospective study of patients with CS from 2006 to 2016. A total of 197 patients with a sarcoidosis diagnosis were screened, and 17 patients (mean age 46.9 years, 59% men) were diagnosed with CS based on Japanese Ministry of Health and Welfare criteria; 53% were diagnosed by a positive MRI, 29% by en...
Source: Danish Medical Journal - Category: General Medicine Tags: Dan Med J Source Type: research
ConclusionsRV or LV EMB can be performed safely during EP procedures and can assist with diagnosis, influencing management. EGM-guided EMB in patients presenting with scar-related VT was low yield for specific pathologies.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
ConclusionsIn conclusion, among patients with extracardiac sarcoidosis and no symptoms of cardiovascular disease, even when EF is preserved, GLS seems to be strongly associated with adverse future events.
Source: Echocardiography - Category: Cardiology Authors: Tags: ORIGINAL INVESTIGATION Source Type: research
Sarcoidosis is an immune-mediated disease that may affect any organ in the body, including the heart.1 Cardiac sarcoidosis (CS) manifests as heart failure, ventricular arrhythmias (including sudden cardiac death), and conduction system disease.2 –5 Although only 5% of patients with systemic sarcoidosis display cardiac symptoms, up to 25% of patients with extracardiac sarcoidosis have cardiac involvement at autopsy.6,7 Furthermore, up to 25% of patients with CS have isolated cardiac sarcoidosis (ICS), which may carry a worse prognosis than nonisolated CS, because patients with ICS more frequently present with left ven...
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: Clinical Investigation Source Type: research
im KB Abstract Sarcoidosis is characterised by granulomatous inflammation in one or more organs, including the heart. Cardiac sarcoidosis generally has non-specific symptoms, and the disease is often diagnosed at a late stage. The condition is associated with cardiomyopathy and arrhythmia and may be fatal. PMID: 29460602 [PubMed - as supplied by publisher]
Source: Tidsskrift for den Norske Laegeforening - Category: General Medicine Authors: Tags: Tidsskr Nor Laegeforen Source Type: research
More News: Arrhythmia | Carbohydrates | Cardiology | Cardiovascular | Heart | Nuclear Medicine | Perfusion | PET Scan | Sarcoidosis | Science | Study