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11.10.2019 | Original Article

The rate of myocardial perfusion recovery after steroid therapy and its implication for cardiac events in cardiac sarcoidosis and primarily preserved left ventricular ejection fraction

Journal of Nuclear Cardiology
MD Kazuhiro Koyanagawa, MD, PhD Masanao Naya, MD, PhD Tadao Aikawa, MD, PhD Osamu Manabe, MD Sho Furuya, MD Masato Kuzume, MD, PhD Noriko Oyama-Manabe, MD, PhD Hiroshi Ohira, MD, PhD Ichizo Tsujino, MD, PhD Toshihisa Anzai
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12350-019-01916-4) contains supplementary material, which is available to authorized users.
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Sarcoidosis is a multisystemic disorder of unknown cause characterized by immune granuloma formation in the involved organs. Few studies have reported on the myocardial perfusion changes by immunosuppression therapy in cardiac sarcoidosis (CS). Additionally, the relationship between myocardial perfusion changes and prognosis is unknown. Therefore, this study aimed to clarify myocardial perfusion recovery after steroid therapy and its prognostic value for major adverse cardiac events (MACE) in patients with CS.

Methods and Results

Thirty-eight consecutive patients with CS {median age, 63 [interquartile range (IQR) 51–68] years; 10 men} underwent both 18F-fluorodeoxyglucose positron emission tomography/computed tomography (CT) and electrocardiography-gated single-photon emission CT (SPECT) pre- and post-steroid therapy. Patients with improved or preserved myocardial perfusion after post-therapy were defined as the recovery group and those with worsened myocardial perfusion as the non-recovery group. Twenty-six patients (68%) were categorized as the recovery group. MACE occurred in eight patients. The Kaplan–Meier curves revealed a significantly higher rate of MACE in the non-recovery group (17.4%/y vs 2.9%/y, P = 0.007).


Myocardial perfusion was recovered by steroid therapy in 61% and preserved in 8% of patients. Myocardial perfusion recovery after steroid therapy was significantly associated with a low incidence of MACE.

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