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Advanced cardiovascular imaging for the evaluation of cardiac sarcoidosis

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Journal of Nuclear Cardiology Aims and scope

Abstract

Cardiac sarcoidosis (CS) remains an intriguing infiltrating disorder and one of the most important forms of inflammatory cardiomyopathy. Identification of patients with CS is of extreme importance because they are at higher risk of sudden death, and heart-failure progression. And while it remains a diagnostic conundrum, a great amount of experience has been accumulated over the last decade with the advent of fluorine-18 fluorodeoxyglucose positron emission tomography and cardiac magnetic resonance with late gadolinium enhancement imaging. They have both proven to be advanced imaging techniques that provide important, and often complementary, diagnostic and prognostic information for the management of CS. However, they have also shown to have limitations, and, thus, there is a continued need for developing more specific imaging probes for identifying cardiac inflammation. The aim of the present manuscript is to provide the reader with a better understanding of the histopathology of the disease, how this potentially relates to noninvasive imaging detection, and the best strategies available for the diagnosis and management of patients with CS.

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Figure 1

Caption based on one autopsy study18

Figure 2

Adapted based on Vita et al44

Figure 3
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Figure 7

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Abbreviations

CS:

Cardiac sarcoidosis

CMR:

Cardiac magnetic resonance imaging

FDG:

Fluorine-18 fluorodeoxyglucose

PET:

Positron emission tomography

LGE:

Late gadolinium enhancement

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Acknowledgments

This work was supported in part by a grant from the National Institutes of Health (1T32HL094301, Dr. Bravo).

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The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Paco E. Bravo MD, Amitoj Singh MD, Marcelo F. Di Carli MD & Ron Blankstein MD

  2. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Paco E. Bravo MD, Marcelo F. Di Carli MD & Ron Blankstein MD

  3. Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Paco E. Bravo MD, Amitoj Singh MD, Marcelo F. Di Carli MD & Ron Blankstein MD

  4. Divisions of Nuclear Medicine and Cardiology, Departments of Radiology and Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Paco E. Bravo MD

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Bravo, P.E., Singh, A., Di Carli, M.F. et al. Advanced cardiovascular imaging for the evaluation of cardiac sarcoidosis. J. Nucl. Cardiol. 26, 188–199 (2019). https://doi.org/10.1007/s12350-018-01488-9

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  • DOI: https://doi.org/10.1007/s12350-018-01488-9

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