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

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Authors: Kiko T, Yoshihisa A, Kanno Y, Yokokawa T, Abe S, Miyata-Tatsumi M, Misaka T, Oikawa M, Kobayashi A, Ishida T, Takeishi Y Abstract Sarcoidosis is a systemic granulomatous disease including heart (cardiac sarcoidosis, CS). It has recently been reported that isolated CS, which presenting primarily cardiac symptoms without clinical evidence of sarcoid involvement in other organs. Diagnostic and prognostic biomarkers of CS, especially in isolated CS, have not yet been established.We studied plasma levels of angiotensin-converting enzyme (ACE), soluble interleukin-2 receptor (sIL-2R), B-type natriuretic peptide ...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Authors: Ho JS, Chilvers ER, Thillai M Abstract INTRODUCTION: Sarcoidosis is a multisystem granulomatous disease predominantly affecting the lungs, with increased risk of cardiovascular disease, pulmonary hypertension and cardiac sarcoidosis (CS), the latter due to direct granuloma infiltration. Sarcoidosis is often managed by chest physicians who need to understand the diagnostic pathways and initial management plans for patients with cardiac involvement. Areas covered: The most serious consequence of CS is sudden cardiac death due to ventricular tachyarrhythmias or complete atrioventricular block. Additional comp...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Petr Kopriva, Martin Griva, Zbynek TüdösAbstractSarcoidosis is a multi-system granulomatous disorder of unclear etiology which can affect any organ of the body including the heart. The heart is involved in up to 25% of sarcoidosis patients. In rare cases, the heart can be the only organ involved.Involvement of the heart, called cardiac sarcoidosis, especially if symptomatic, significantly deteriorates the prognosis for sarcoidosis patients, which is why cardiac sarcoidosis should be not only considered, but also searched for actively. D...
Source: Cor et Vasa - Category: Cardiology Source Type: research
ConclusionLeft ventricle MC is very rare. The dystrophic MC from ischemic origin is the most frequent. At long-term follow-up, 59% of MC had altered LVEF, it is more frequent (80%) in I-MC. The extent of LV MC was associated with high risk of cardiac death and ventricular arrhythmia.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Petr Kopriva, Martin Griva, Zbynek TüdösAbstractSarcoidosis is a multi-system granulomatous disorder of unclear etiology which can affect any organ of the body including the heart. The heart is involved in up to 25% of sarcoidosis patients. In rare cases, the heart can be the only organ involved.Involvement of the heart, called cardiac sarcoidosis, especially if symptomatic, significantly deteriorates the prognosis for sarcoidosis patients, which is why cardiac sarcoidosis should be not only considered, but also searched for actively. D...
Source: Cor et Vasa - Category: Cardiology Source Type: research
ConclusionLeft ventricle MC is very rare. The dystrophic MC from ischemic origin is the most frequent. At long-term follow-up, 59% of MC had altered LVEF, it is more frequent (80%) in I-MC. The extent of LV MC was associated with high risk of cardiac death and ventricular arrhythmia.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
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
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