Abstract
Background
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).
Conclusions
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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Abbreviations
- CS:
-
Cardiac sarcoidosis
- SPECT:
-
Single-photon emission computed tomography
- FDG:
-
18F-fluorodeoxyglucose
- PET:
-
Positron emission tomography
- CT:
-
Computed tomography
- SRS:
-
Summed rest score
- BW:
-
Bandwidth
- MACE:
-
Major adverse cardiac events
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Dr. Aikawa is affiliated with the endowed department of Medtronic Japan Co., Ltd. and Win International Co., Ltd. All other authors have no conflicts of interest to disclose.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Informed consent was waived due to the retrospective study design.
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Koyanagawa, K., Naya, M., Aikawa, T. et al. 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. J. Nucl. Cardiol. 28, 1745–1756 (2021). https://doi.org/10.1007/s12350-019-01916-4
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DOI: https://doi.org/10.1007/s12350-019-01916-4