The Utility of Cardiac Magnetic Resonance Imaging in the Diagnosis of Cardiac Sarcoidosis

Heart, Lung & Circulation
Kelly M StantonRajesh Puranik

Abstract

Autopsy reports suggest that cardiac sarcoidosis occurs in 20 to 25% of patients with pulmonary sarcoidosis, yet the clinical ante-mortem diagnosis is made in only 5% of cases. Current diagnostic algorithms are complex and lack sensitivity. Cardiac Magnetic Resonance imaging (CMR) provides an opportunity to detect myocardial involvement in sarcoidosis. The aim of this study is to determine the prevalence and clinical significance of late gadolinium enhancement (LGE) on CMR in patients with sarcoidosis. Consecutive patients with biopsy-proven sarcoidosis undergoing CMR were retrospectively evaluated for cardiac sarcoidosis. Medical records were correlated with CMR. Forty-six patients were evaluated. Late gadolinium enhancement was present in 22%, indicating myocardial involvement, and 70% had corresponding hyper-intense T2 signal indicating active inflammation. Late gadolinium enhancement was 18%+/-9.7% of overall left ventricular (LV) mass and most commonly located in the basal to mid septum. There was no association between LGE and cardiovascular symptoms or pulmonary stage. Eighty per cent of patients with LGE did not fulfill conventional diagnostic criteria for cardiac sarcoidosis. However, LGE was associated with clinically...Continue Reading

Citations

Jul 12, 2018·Cardiology in Review·Zaneta SmolenskaZbigniew Zdrojewski
May 9, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Pier-Valerio MariLuca Richeldi
Apr 16, 2020·American Journal of Respiratory and Critical Care Medicine·Elliott D CrouserRobert P Baughman
Jun 4, 2019·Heart·Logan L VincentEric V Krieger
Jan 18, 2019·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Jianxiong ZhangHaoyan Wang
Sep 19, 2020·PloS One·Patrice CacoubLucie Biard
Sep 26, 2020·European Heart Journal. Case Reports·Peter J KennelIrina Sobol
Jun 5, 2021·Korean Circulation Journal·Noriko Oyama-ManabeSatonori Tsuneta

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