Abstract 12397: Detection of Cardiac Involvement in Patients with Sarcoidosis Using Cardiac Magnetic Resonance
Background: Sarcoidosis is a multiple organ granulomatous disease and cardiac involvement often leads to adverse outcomes. Since cardiac involvement can progress without evident symptoms, it is difficult to detect cardiac involvement in the early phase. Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) enables assessment of cardiac function and myocardial damage with high spatial resolution.
Methods and Results: Twenty-three patients with biopsy-proven sarcoidosis (63 ± 10 years old) underwent a comprehensive cardiological work-up including gadolinium-enhanced CMR to evaluate cardiac involvement. Thirteen (56.5%) of the 23 patients had LGE, and LGE was frequently observed at the subepicardial layer of basal and inferolateral segments. Patients with LGE had significantly lower LVEF and higher BNP levels than those of patients without LGE (LVEF: 46 ± 4 vs. 58 ± 2%, P<0.05; BNP: 158 ± 40 vs. 33 ± 6 pg/ml, P<0.05). However, 40% of the patients with LGE were asymptomatic, and ECG was normal in 13% of the patients with LGE. Furthermore, echocardiography showed LV dysfunction or segmental wall motion abnormalities only in 54% of the patients with LGE. Diagnosis of cardiac sarcoidosis was made in 8 (34.8%) of the 23 patients, and all of the eight patients had LGE. Interestingly, one patient who had subtle LGE at the inferolateral segment without regional wall motion abnormalities and AV block developed cardiac sarcoidosis with marked LGE 1.7 years after initial assessment (Figure). Follow-up CMR was performed in four cardiac sarcoidosis patients who received corticosteroid therapy, and percentage of LGE was decreased in all of the four patients.
Conclusions: Compared with other modalities, CMR is sensitive for detecting cardiac involvement in patients with sarcoidosis. Serial assessment of myocardial damage using CMR may be useful to detect cardiac involvement in the early phase.
- © 2011 by American Heart Association, Inc.