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Localization of myocardial FDG uptake for prognostic risk stratification in corticosteroid-naïve cardiac sarcoidosis

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

A Correction to this article was published on 29 July 2021

This article has been updated

Abstract

Background

The localization of myocardial 18F-fluorodeoxyglucose (FDG) uptake affecting long-term clinical outcomes has not been elucidated in patients with corticosteroid-naïve cardiac sarcoidosis (CS).

Objectives

This study sought to investigate the localization of myocardial FDG uptake on positron emission tomography (PET) and myocardial perfusion abnormality to predict adverse events (AEs) for a long-term follow-up in patients with corticosteroid-naïve CS.

Methods

Consecutive 90 patients with clinical suspicion of CS who underwent FDG-PET imaging to assess for inflammation were enrolled. AEs were defined as a composite of sustained ventricular tachycardia (VT), heart transplantation, and all-cause death, which were ascertained by medical records, defibrillator interrogation, and telephone interviews.

Results

Of 90 patients, 42 patients (mean age 62.9 ± 12.0 years; 76.2% females) were confirmed active cardiac involvement. Over a median follow-up of 4.9 years, 15 patients with CS experienced AEs including 6 sustained ventricular tachycardias (VT) and 9 deaths. Cox proportional-hazards model after adjustment for left ventricular systolic dysfunction revealed that FDG uptake in the right ventricle (RV) or basal anterolateral area of the left ventricle (LV) with myocardial perfusion abnormality was predictive of AEs.

Conclusions

FDG uptake in the RV or basal anterolateral area of the LV with myocardial perfusion abnormality provides long-term prognostic risk stratification in patients with corticosteroid-naïve CS.

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Abbreviations

LV:

Left ventricular

FDG:

18F-fluorodeoxyglucose

PET:

Positron emission tomography

CS:

Cardiac sarcoidosis

AE:

Adverse event

HbA1c:

Glycated hemoglobin

FFA:

Free fatty acid

ACE:

Angiotensin-converting enzyme

BNP:

Brain natriuretic peptide

NT-pro-BNP:

N-terminal pro-BNP

SUV:

Standardized uptake value

SD:

Standard deviation

COV:

Coefficient of variation

RV:

Right ventricular

Tc-MIBI:

99mTechnetium-methoxy-isobutylisonitrile

SRS:

Summed rest score

JMHW:

Japanese Ministry of Health and Welfare

ICD:

Implantable cardioverter defibrillator

VT:

Ventricular tachycardia

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Acknowledgements

We thank Mami Nakayama, Miho Nakao-Kogure, Katsue Shiramizu, Miyuki Nishikata, Yuri Nishino, Makiko Kiyohiro (Kurume University), and Kouichi Nitta (Hitachi Ltd., Tokyo, Japan) for their technical assistance.

Disclosures

All authors have nothing to disclose regarding the current study.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan

    Munehisa Bekki MD, Nobuhiro Tahara MD, PhD, Atsuko Tahara MD, Yoichi Sugiyama MD, PhD, Shoko Maeda-Ogata MD, Akihiro Honda MD, PhD, Sachiyo Igata MD, Mika Enomoto MD, PhD & Yoshihiro Fukumoto MD, PhD

  2. Biostatics Center, Kurume University, Kurume, Japan

    Tatsuyuki Kakuma MPH, PhD

  3. Department of Radiology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan

    Hayato Kaida MD, PhD

  4. Department of Radiology, Kurume University School of Medicine, Kurume, Japan

    Toshi Abe MD, PhD

Authors
  1. Munehisa Bekki MD
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  2. Nobuhiro Tahara MD, PhD
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  3. Atsuko Tahara MD
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  4. Yoichi Sugiyama MD, PhD
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  5. Shoko Maeda-Ogata MD
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  7. Sachiyo Igata MD
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  8. Mika Enomoto MD, PhD
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  9. Tatsuyuki Kakuma MPH, PhD
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  10. Hayato Kaida MD, PhD
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  11. Toshi Abe MD, PhD
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  12. Yoshihiro Fukumoto MD, PhD
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Corresponding author

Correspondence to Nobuhiro Tahara MD, PhD.

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The original online version of this article was revised: The original article file and the supplementary material file MOESM2_ESM was published with an incorrect Figure 3A.

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Bekki, M., Tahara, N., Tahara, A. et al. Localization of myocardial FDG uptake for prognostic risk stratification in corticosteroid-naïve cardiac sarcoidosis. J. Nucl. Cardiol. 29, 2132–2144 (2022). https://doi.org/10.1007/s12350-021-02684-w

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  • DOI: https://doi.org/10.1007/s12350-021-02684-w

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