Abstract 10959: Focal Inflammation in Basal Septal Segment is Related to the Development of A-V Nodal Dysfunction in Cardiac Sarcoidosis
Background: We hypothesized that focal inflammation would be related to development of cardiac events in patients with cardiac sarcoidosis (CS).
Purpose: To assess the relationship between advanced A-V block (AAVB), the most common cardiac event, and inflammation using fluorodeoxyglucose (FDG)-PET in CS patients.
Methods: Thirty-nine CS patients (13 with and 26 without AAVB; groups AAVB+ and AAVB-) who were diagnosed by consensus criteria were studied. FDG-PET and MRI were performed on the same day immediately after diagnosis of CS and before implantation of permanent pacemaker. Delayed-enhancement in MR image was defined as myocardial fibrosis, and FDG uptake in PET image as myocardial inflammation. The left ventricle were divided into 16 segments and analyzed.
Result: There was no difference in age, gender, steroid use, angiotensin-converting enzyme, serum and urinary calcium and high sensitive C-reactive protein between the 2 groups. Focal FDG uptake in the basal septal portion, which is a site of A-V nodal pathway, was observed in 10 patients (77%) of AAVB+, while those in 5 patients (19%) of AAVB- (p = 0.003). On the other hand, DE in the basal portion was observed in 12 patients (92%) of AAVB+ and 18 patients (69%) of AAVB-, and there was no significant difference between 2 groups (p = 0.111).
Conclusion: Advanced A-V nodal block in CS was strongly related with inflammation of sarcoid lesion in the A-V nodal pathway than myocardial fibrosis.
- © 2013 by American Heart Association, Inc.