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Cardiac involvement accounts for the majority of morbidity and mortality in sarcoidosis. Pathological myocardial fluorodeoxyglucose (FDG)-uptake in positron emission tomography (PET) has been associated with cardiovascular events and quantitative metabolic parameters have been shown to add prognostic value. Our aim was to study whether the pattern of pathological cardiac FDG-uptake and quantitative parameters are able to predict cardiovascular events in patients with suspected cardiac sarcoidosis (CS).
137 FDG-PET examinations performed in Tampere University Hospital were retrospectively analyzed visually and quantitatively. Location of pathological uptake was noted and pathological metabolic volume, average standardized uptake value (SUV), and total cardiac metabolic activity (tCMA) were calculated. Patients were followed for ventricular tachycardia, decrease in left ventricular ejection fraction, and death.
Eleven patients had one or more cardiovascular events during the follow-up. Five patients out of 12 with uptake in both ventricles had an event during follow-up. Eight patients had high tCMA (> 900 MBq) and three of them had a cardiovascular event. Right ventricular uptake and tCMA were significantly associated with cardiovascular events during follow-up (P-value .001 and .018, respectively).
High tCMA and right ventricular uptake were significant risk markers for cardiac events among patient with suspected CS.
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Bravo PE, Raghu G, Rosenthal DG, et al. Risk assessment of patients with clinical manifestations of cardiac sarcoidosis with positron emission tomography and magnetic resonance imaging. Int J Cardiol 2017;241:457-62. https://doi.org/10.1016/j.ijcard.2017.03.033. CrossRefPubMedPubMedCentral
Tuominen H, Haarala A, Tikkakoski A, et al. 18F-FDG-PET in finnish patients with clinical suspicion of cardiac sarcoidosis: Female sex and history of atrioventricular block increase the prevalence of positive PET findings. J Nucl Cardiol 2017. https://doi.org/10.1007/s12350-017-0940-x
Ishiyama M, Soine LA, Vesselle HJ. Semi-quantitative metabolic values on FDG PET/CT including extracardiac sites of disease as a predictor of treatment course in patients with cardiac sarcoidosis. EJNMMI Res 2017;7(1):67-017-0315-y.
- FDG-PET in possible cardiac sarcoidosis: Right ventricular uptake and high total cardiac metabolic activity predict cardiovascular events
MD Heikki Tuominen
MD, PhD Atte Haarala
MD Antti Tikkakoski
MD, PhD Mika Kähönen
MD, PhD Kjell Nikus
MD, PhD Kalle Sipilä
- Springer International Publishing
Journal of Nuclear Cardiology
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
Neu im Fachgebiet Kardiologie
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