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The Role of Multimodality Imaging in Cardiac Sarcoidosis
Noriko Oyama-Manabe,Osamu Manabe,Tadao Aikawa,Satonori Tsuneta 대한심장학회 2021 Korean Circulation Journal Vol.51 No.7
The etiology and the progression of sarcoidosis remain unknown. However, cardiac sarcoidosis (CS) is significantly associated with a poor prognosis due to the associated congestive heart failure, arrhythmias (such as an advanced atrioventricular block), and ventricular tachyarrhythmia. Novel imaging modalities are now available to detect CS lesions secondary to active inflammation, granuloma formation, and fibrotic changes. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and cardiac magnetic resonance imaging (CMR) play essential roles in diagnosing and monitoring patients with confirmed or suspected CS. The following focused review will highlight the emerging role of non-invasive cardiac imaging techniques, including FDG PET/CT and CMR.
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Manabe Osamu,Oyama-Manabe Noriko,Naya Masanao,Obara Masahiko,Kikuchi Yasuka,Aikawa Tadao,Tomiyama Yuuki,Sugimori Hiroyuki,Katoh Chietsugu,Tamaki Nagara,Anzai Toshihisa 아시아심장혈관영상의학회 2019 Cardiovascular Imaging Asia Vol.3 No.1
Objective: Although the relationship between coronary stenosis and myocardial perfusion is well established, little is known regarding the contribution of subendocardial infarction to this relationship. The purpose of this study was to evaluate the effects of obstructive coronary stenosis and subendocardial infarction on myocardial flow reserve (MFR). Materials and Methods: Fifty-four patients with suspected and known coronary artery disease (CAD) who underwent perfusion 3T-MRI and invasive angiography were studied. The time-intensity curves of the left ventricle tissue and cavity were fitted by a single-compartment model to compute myocardial blood flow (MBF). Global MFR and regional MFR were calculated by dividing stress MBF by rest MBF. Myocardial infarction lesions were assessed by late gadolinium enhancement. The effects of obstructive coronary stenosis and subendocardial infarction on the regional MFR were evaluated. Results: Obstructed vessels (≥70% diameter stenosis for main vessels or ≥50% for left main) were observed in 65 out of 162 vessels. Further analysis demonstrated that MFR in obstructed vessels was significantly lower than that in non-obstructed vessels {1.48 [the interquartile range (IQR) : 1.31–2.03] vs. 1.84 (IQR: 1.44–2.46), p=0.01}. After excluding vessels with transmural infarction (n=19), the MFR for vessels with subendocardial infarction (n=20) was significantly lower than the MFR for non-infarction vessels (n=123) [1.48 (IQR: 1.40–1.79) vs. 1.88 (IQR: 1.41–2.48), p=0.02]. Conclusion: Subendocardial infarction in addition to obstructive coronary atherosclerosis might be associated with an impairment of regional MFR in patients with CAD.
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