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Utility of gallium-67 scintigraphy for evaluation of cardiac sarcoidosis with ventricular tachycardia

  • Hideki Futamatsu
  • Jun-ichi Suzuki
  • Susumu Adachi
  • Hiroyuki Okada
  • Kenichiro Otomo
  • Takahiro Ohara
  • Yuji Hashimoto
  • Tsunekazu Kakuta
  • Yoshito Iesaka
  • Hiroaki Yamaguchi
  • Harumizu Sakurada
  • Akira Sato
  • Tohru Obayashi
  • Akihiro Niwa
  • Kenzo Hirao
  • Mitsuaki IsobeEmail author
Article

Abstract

Background

The outcome of cardiac sarcoidosis is sometimes very poor. Ventricular tachycardia (VT) associated with cardiac sarcoidosis is the most common cause of sudden death among most patients. However, there is no established method for potential VT in patients with cardiac sarcoidosis. Thus, we investigated the utility of evaluation of gallium-67 scintigraphy for potential VT in patients with cardiac sarcoidosis.

Methods and Results

Cardiac sarcoidosis was diagnosed in 25 patients at ours or collaborating hospitals during the period 1982 through 2004. Twenty-one of these patients were treated with corticosteroid, and these patients were divided into two groups, depending on whether VT was present: a non-VT group (n=7) and a VT group (n=14). Laboratory and gallium-67 scintigraphy findings were examined in both groups. During the follow-up period, initial and maintenance dosages of corticosteroid did not differ significantly between the groups. Accumulation of gallium-67 in the heart at the time of diagnosis was detected more frequently in the VT group than in the non-VT group (14.3 vs. 71.4%, p<0.05). Six of the seven VT patients who underwent follow-up examination showed improvement on the scintigram obtained after treatment. Five of the six showed no VT recurrence in terms of Holter electrocardiogram, electrophysiologic study, or delivery of implantable cardioverter defibrillator shock. Serum angiotensin-converting enzyme and lysozyme concentrations were within normal limits in most patients in both groups.

Conclusions

Activity of sarcoid granulomas may be associated with the occurrence of VT. Gallium-67 scintigraphy reflects the activity of sarcoid granulomas and thus is useful for evaluation of cardiac sarcoidosis in patients with potential VT.

Keywords

cardiac sarcoidosis corticosteroid therapy gallium-67 scintigraphy ventricular tachycardia 

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Notes

Acknowledgment

The investigators thank Drs Nobuo Toshida and Naoto Yamamoto at Soka City Hospital and Dr Keiji Nishiyama at National Hospital Tokyo Disaster Medical Center for providing patient data for this study.

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Hideki Futamatsu
    • 1
  • Jun-ichi Suzuki
    • 1
  • Susumu Adachi
    • 1
  • Hiroyuki Okada
    • 1
  • Kenichiro Otomo
    • 2
  • Takahiro Ohara
    • 3
  • Yuji Hashimoto
    • 3
  • Tsunekazu Kakuta
    • 4
  • Yoshito Iesaka
    • 4
  • Hiroaki Yamaguchi
    • 5
  • Harumizu Sakurada
    • 5
  • Akira Sato
    • 6
  • Tohru Obayashi
    • 7
  • Akihiro Niwa
    • 7
  • Kenzo Hirao
    • 1
  • Mitsuaki Isobe
    • 1
    • 8
    Email author
  1. 1.Department of Cardiovascular MedicineTokyo Medical and Dental UniversityTokyoJapan
  2. 2.Department of CardiologyOume Municipal General HospitalTokyoJapan
  3. 3.Department of CardiologyKameda Medical CenterChibaJapan
  4. 4.Cardiovascular CenterTsuchiura Kyodo HospitalIbarakiJapan
  5. 5.Department of CardiologyTokyo Metropolitan Hiroo General HospitalTokyoJapan
  6. 6.Department of CardiologyYokosuka Kyosai General HospitalKanagawaJapan
  7. 7.Department of CardiologyMusashino Red Cross HospitalTokyoJapan
  8. 8.Department of Cardiovascular MedicineTokyo Medical and Dental UniversityTokyoJapan

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