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16.03.2021 | ORIGINAL ARTICLE

Prognosis and recurrence in cardiac sarcoidosis: Serial assessment of BMIPP SPECT and FDG-PET

verfasst von: Atsushi Yamamoto, MD, Michinobu Nagao, MD, Eri Watanabe, MD, Yasutaka Imamura, MD, Atsushi Suzuki, MD, Kenji Fukushima, MD, Kiyoe Ando, MD, Risako Nakao, MD, Akiko Sakai, MD, Mitsuru Momose, MD, Shuji Sakai, MD, Nobuhisa Hagiwara, MD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 3/2021

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Abstract

Background

We analyzed ¹⁸F-Fludeoxyglucose positron emission tomography (FDG-PET) and ¹²³I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) performed for cardiac sarcoidosis (CS) patients taking prednisolone, identified recurrence by FDG-PET, and investigated BMIPP as a recurrence and prognostic factor in CS.

Methods and Results

CS patients who underwent BMIPP and FDG-PET within 2 months were enrolled. The recurrence-free group included patients with standardized uptake value (SUVmax) < 4 in the myocardium consecutively for ≥ 2 years. The total BMIPP SPECT defect score (BDS) was used to estimate myocardial damage. The predictability of the initial BDS and SUVmax for major adverse cardiac events (MACE) was analyzed using Kaplan–Meier analysis. Overall, 73 patients and 250 BMIPP and FDG-PET sets were analyzed retrospectively (mean follow-up, 3.5 years). The BDS was significantly greater for the recurrence group (N = 21) vs recurrence-free group (20 ± 13 vs 14 ± 12, P = 0.041). Patients with BDS ≥16 had a significantly higher MACE rate than patients with BDS < 16 (log-rank test, P = 0.016). However, MACE occurrence was comparable between patients with SUVmax ≥ 4 and < 4.

Conclusions

BDS is a predictive marker of recurrence and MACE. SUV is not related to MACE. Recurrence, defined by prednisolone treatment-induced SUV variability, was observed in approximately 30% of CS patients.

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Titel: Prognosis and recurrence in cardiac sarcoidosis: Serial assessment of BMIPP SPECT and FDG-PET
verfasst von: Atsushi Yamamoto, MD
Michinobu Nagao, MD
Eri Watanabe, MD
Yasutaka Imamura, MD
Atsushi Suzuki, MD
Kenji Fukushima, MD
Kiyoe Ando, MD
Risako Nakao, MD
Akiko Sakai, MD
Mitsuru Momose, MD
Shuji Sakai, MD
Nobuhisa Hagiwara, MD
Publikationsdatum: 16.03.2021
Verlag: Springer International Publishing
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 3/2021
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-021-02567-0

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Prognosis and recurrence in cardiac sarcoidosis: Serial assessment of BMIPP SPECT and FDG-PET