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Detection of Active Inflammation Status Around Ventricular Aneurysms in Patients With Cardiac Sarcoidosis

Takuma Nanno1, Shigeki Kobayashi1, Ryosuke Yoshitomi1

  • 1Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine.

Circulation Journal : Official Journal of the Japanese Circulation Society
|October 22, 2019
PubMed

Insights

In cardiac sarcoidosis with ventricular aneurysm, 18F-FDG PET shows high uptake around the aneurysm but not within it. This pattern may help diagnose and manage this complex condition.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Immunology

Background:

  • Cardiac sarcoidosis (CS) is an inflammatory condition affecting the heart.
  • Ventricular aneurysms (VA) can complicate CS, but patterns of 18F-FDG uptake are poorly understood.

Purpose of the Study:

  • To investigate the pattern of 18F-fluorodeoxyglucose (18F-FDG) accumulation in the heart using positron emission tomography (PET) in patients with CS and VA.

Main Methods:

  • Prospective enrollment of 82 CS patients, with 54 active CS patients divided into VA (n=17) and non-VA (n=37) groups.
  • Analysis of 18F-FDG uptake patterns in the heart, comparing uptake around and within VA, and in areas of left ventricular (LV) wall thinning.

Main Results:

  • Patients with VA showed strong 18F-FDG uptake surrounding the VA, with minimal uptake within the VA center (5.1±2.1 vs. 2.2±0.6, P=0.0003).
  • In non-VA patients with LV wall thinning, significant 18F-FDG accumulation was observed in thinned areas (3.1±0.8 vs. 2.0±0.6, P=0.00002).

Conclusions:

  • A distinct pattern of 18F-FDG accumulation around VA, with decreased uptake within, may characterize CS with VA.
  • Understanding these FDG uptake patterns can enhance CS pathophysiology insights and guide early VA treatment.
Abstract

Keywords:
18F-fluorodeoxyglucose positron emission tomographyCardiac sarcoidosisVentricular aneurysm

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