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18F-FDG-PET in Finnish patients with clinical suspicion of cardiac sarcoidosis: Female sex and history of atrioventricular block increase the prevalence of positive PET findings

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Journal of Nuclear Cardiology Aims and scope

Abstract

Introduction

Fluorodeoxyglucose positron emission tomography (FDG-PET) is a non-invasive imaging modality that has been shown to be a feasible method to demonstrate myocardial inflammation. The aim of this study was to identify the patients suspected of having cardiac sarcoidosis (CS), who are most likely to benefit from PET imaging.

Materials and methods

137 patients suspected of having CS underwent a dedicated cardiac FDG-PET examination at Tampere University Hospital between August 2012 and September 2015. These examinations were retrospectively analyzed.

Results

33 and 12 of the 137 patients had abnormal left and right ventricular (LV and RV) FDG-uptake, respectively. Abnormal LV-uptake and RV-uptake were significantly associated with female sex and a history of advanced AV-block (P < 0.05). Abnormal RV-uptake was also associated with ventricular tachycardia and atrial fibrillation (P < 0.05). 56% of the 27 female patients with a history of AV-block had a pathological PET finding compared to only 6% of the 49 male patients without a history of AV-block. There were 17 female patients with history of both AV-block and ventricular tachycardia, 71% of them had abnormal PET finding.

Conclusions

Abnormal FDG-PET findings were associated with female sex, AV-block, and arrhythmias in this clinical cohort.

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Abbreviations

CS:

Cardiac sarcoidosis

EMB:

Endomyocardial biopsy

FDG-PET:

18Fluorodeoxyglucose positron emission tomography

RV:

Right ventricle

LV:

Left ventricle

AV:

Atrioventricular

VT:

Ventricular tachycardia

MPI:

Myocardial perfusion imaging

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Acknowledgements

We want to thank Tiit Kööbi, MD, PhD, for his invaluable contributions to PET-CT imaging in Tampere University Hospital. Additionally, we want to thank all the technicians in the Nuclear Medicine and Radiology departments of Tampere University Hospital. This study was financially supported by Grants from Finska Läkaresällskapet and the Tampere University Hospital Medical Fund.

Disclosure

All authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital, 33520, Tampere, Finland

    Heikki Tuominen MD, Atte Haarala MD, PhD, Antti Tikkakoski MD, Pasi Korkola Lic.Tech & Kalle Sipilä MD, PhD

  2. Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland

    Mika Kähönen MD, PhD & Kjell Nikus MD, PhD

  3. Heart Center, Tampere University Hospital, Tampere, Finland

    Kjell Nikus MD, PhD

Authors
  1. Heikki Tuominen MD
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  2. Atte Haarala MD, PhD
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  3. Antti Tikkakoski MD
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  4. Pasi Korkola Lic.Tech
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  5. Mika Kähönen MD, PhD
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  6. Kjell Nikus MD, PhD
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  7. Kalle Sipilä MD, PhD
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Correspondence to Heikki Tuominen MD.

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Funding This study was funded by Finska Läkaresällskapet.

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Tuominen, H., Haarala, A., Tikkakoski, A. et al. 18F-FDG-PET in Finnish patients with clinical suspicion of cardiac sarcoidosis: Female sex and history of atrioventricular block increase the prevalence of positive PET findings. J. Nucl. Cardiol. 26, 394–400 (2019). https://doi.org/10.1007/s12350-017-0940-x

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  • DOI: https://doi.org/10.1007/s12350-017-0940-x

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