Cardiac sarcoidosis: Applications of imaging in diagnosis and directing treatment

Heart

Volumn 97, Issue 24, 2011, Pages 2078-2087

  Youssef, George ^a   Beanlands, Rob S B ^a   Birnie, David H ^a   Nery, Pablo B ^a  

^a UNIVERSITY OF OTTAWA HEART INSTITUTE   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIMALARIAL AGENT; CORTICOSTEROID; CYCLOPHOSPHAMIDE; FLUORODEOXYGLUCOSE; GALLIUM 67; INFLIXIMAB; METHOTREXATE; PLACEBO; PREDNISONE; TECHNETIUM 99M; THALIDOMIDE; THALLIUM 201;

CARDIAC SARCOIDOSIS; CARDIOVASCULAR MAGNETIC RESONANCE; CLINICAL FEATURE; CONGESTIVE CARDIOMYOPATHY; CONGESTIVE HEART FAILURE; CORONARY ARTERY DISEASE; DEFIBRILLATOR; DEVICE THERAPY; DIAGNOSTIC IMAGING; DIFFERENTIAL DIAGNOSIS; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAPHY; HEART ATRIUM ARRHYTHMIA; HEART DISEASE; HEART ELECTROPHYSIOLOGY; HEART MUSCLE BIOPSY; HEART RIGHT VENTRICLE DYSPLASIA; HEART TRANSPLANTATION; HEART VENTRICLE ARRHYTHMIA; HOLTER MONITORING; HUMAN; IMAGE ANALYSIS; MYOCARDITIS; OUTCOME ASSESSMENT; PATHOGENESIS; POSITRON EMISSION TOMOGRAPHY; PRIORITY JOURNAL; PROGNOSIS; REVIEW; SARCOIDOSIS; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY; SUDDEN DEATH;

CARDIAC PACING, ARTIFICIAL; CARDIOMYOPATHIES; DIAGNOSIS, DIFFERENTIAL; DIAGNOSTIC TECHNIQUES, CARDIOVASCULAR; HEART TRANSPLANTATION; HUMANS; IMMUNOSUPPRESSIVE AGENTS; INCIDENCE; PRACTICE GUIDELINES AS TOPIC; PROGNOSIS; SARCOIDOSIS; WORLD HEALTH;

EID: 82255186042     PISSN: 13556037     EISSN: 1468201X     Source Type: Journal    
DOI: 10.1136/hrt.2011.226076     Document Type: Review

References (22)

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2. Silverman KJ, Hutchins GM, Bulkley BH. Cardiac sarcoid: a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation 1978;58:1204-11. Landmark retrospective study looking at the incidence of antemortem clinical manifestations and postmortem evidence of myocardial lesions in necropsied patients with sarcoidosis. (Pubitemid 9092005)
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5. Sharma OP, Maheshwari A, Thaker K. Myocardial sarcoidosis. Chest 1993;103:253-8. One of the early excellent review articles about CS discussing different diagnostic modalities and treatment options. (Pubitemid 23027268)
6. Roberts WC, McAllister HA Jr, Ferrans VJ, et al. Sarcoidosis of the heart. A clinicopathologic study of 35 necropsy patients (group I) and review of 78 previously described necropsy patients (group II). Am J Med 1977;63:86-108. An excellent retrospective clinicopathologic study of 113 necropsy patients with CS, detailing prevalence, clinical manifestations, pathologic features, and prognosis.
7. Okura Y, Dec GW, Hare JM, et al. A clinical and histopathologic comparison of cardiac sarcoidosis and idiopathic giant cell myocarditis. J Am Coll Cardiol 2003;41:322-9. The goal of this study was to determine the prognostic value of clinical data and histology in CS and idiopathic giant cell myocarditis. Presentation with heart block or >9 weeks of symptoms predicted CS. Also, the study highlighted that isolated CS may exist without evidence of extracardiac involvement in two thirds of the cases.
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12. Tahara N, Tahara A, Nitta Y, et al. Heterogeneous myocardial FDG uptake and the disease activity in cardiac sarcoidosis. JACC Cardiovasc Imaging 2010;3:1219-28. This is the first study to evaluate the pattern of FDG uptake in CS compared to dilated cardiomyopathy patients and normal controls using the coefficient of variance. CS showed a heterogeneous pattern and its COV values decreased after steroid treatment.
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15. Patel MR, Cawley PJ, Heitner JF, et al. Detection of myocardial damage in patients with sarcoidosis. Circulation 2009;120:1969-77. This is the first prospective study evaluating the utility of delayed enhancement-CMR imaging in asymptomatic patients with biopsy proven extracardiac sarcoidosis. CS was detected in 26% of patients and the presence of myocardial delayed enhancement was associated with adverse outcomes including SCD.
16. Smedema JP, Snoep G, van Kroonenburgh MP, et al. Evaluation of the accuracy of gadolinium-enhanced cardiovascular magnetic resonance in the diagnosis of cardiac sarcoidosis. J Am Coll Cardiol 2005;45:1683-90. This is a recent large study analysing the accuracy of gadolinium enhanced cardiovascular magnetic resonance for the diagnosis of CS. (Pubitemid 40704507)
17. Langah R, Spicer K, Gebregziabher M, et al. Effectiveness of prolonged fasting 18F-FDG PET-CT in the detection of cardiac sarcoidosis. J Nucl Cardiol 2009;16:801-10. This is a recent study comparing the accuracy of prolonged fasting FDG PET and gallium scintigraphy for detecting active CS. FDG PET proved to have a higher diagnostic accuracy.
18. Youssef G, Leung E, Williams K, et al. The use of 18F-FDG PET imaging in diagnosis of cardiac sarcoid, a systematic review including the UOHI experience. Can J Cardiol 2010;26 (Suppl D):96D.
19. Kandolin R, Lehtonen J, Graner M, et al. Diagnosing isolated cardiac sarcoidosis. J Intern Med 2011 May 2. doi:10.1111/ j.1365-2796.2011.02396.x. [Epub ahead of print]
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21. Chiu CZ, Nakatani S, Zhang G, et al. Prevention of left ventricular remodeling by long-term corticosteroid therapy in patients with cardiac sarcoidosis. Am J Cardiol 2005;95: 143-6. In this study, 43 patients with CS were studied echocardiographically before and after steroid treatment; this showed the effectiveness of steroids in preventing LV remodelling and improving contractility in earlier stages compared to late stages.
22. Kato Y, Morimoto S, Uemura A, et al. Efficacy of corticosteroids in sarcoidosis presenting with atrioventricular block. Sarcoidosis Vasc Diffuse Lung Dis 2003;20:133-7. (Pubitemid 36841694)