Imaging in Suspected Cardiac Sarcoidosis: A Diagnostic Challenge.

Imaging in Suspected Cardiac Sarcoidosis: A Diagnostic Challenge. Curr Cardiol Rev. 2019 Jul 25;: Authors: Ha FJ, Agarwal S, Tweed K, Palmer SC, Adams HS, Thillai M, Williams L Abstract Cardiac sarcoidosis (CS) represents a unique diagnostic dilemma. Guidelines have been recently revised to reflect the increasingly established role of sophisticated imaging techniques. Trans-thoracic echocardiography (TTE) is widely adopted for initial screening of CS. Contemporary TTE techniques could enhance detection of subclinical LV dysfunction, particularly left ventricular (LV) global longitudinal strain assessment which predicts event-free survival (meta-analysis of 5 studies, hazard ratio 1.28, 95% confidence interval 1.18-1.37, p<0.0001). However, despite wide availability of TTE, it has limited sensitivity and specificity for CS diagnosis. Cardiac magnetic resonance imaging (CMR) is a crucial diagnostic modality for suspected CS. Presence of late gadolinium enhancement signifies myocardial scar and enables risk stratification. Fluorodeoxyglucose positron emission tomography (FDG-PET) coupled with myocardial perfusion imaging can identify active CS and guide immunosuppressant therapy. Gallium scintigraphy may be considered although FDG-PET is often preferred. While CMR and FDG-PET provide complementary information in CS evaluation, current guidelines do not recommend which advanced imaging modalities are essential in suspected CS and ...
Source: Current Cardiology Reviews - Category: Cardiology Tags: Curr Cardiol Rev Source Type: research