Abstract 15452: Usefulness of Combination of FDG-PET and Speckle-Tracking Echocardiography to Predict Steroid Responders in Cardiac Sarcoidosis
Background: We hypothesized that preserved contractility as well as inflammation would be needed for achievement wall motion recovery after steroid therapy in patients with cardiac sarcoidosis (CS).
Purpose: To assess whether fluorodeoxyglucose (FDG)-PET and two-dimensional speckle-tracking echocardiography (2DSTE) can predict the steroid responder in CS patients.
Methods: Fourteen CS patients who were diagnosed by consensus criteria of CS were studied. FDG-PET and comprehensive echocardiography were performed before steroid therapy, and consecutively peak circumferential, longitudinal and radial strains were assessed by 2DSTE software in LV 16-segment model. A segment was considered to demonstrate functional improvement after steroid therapy if it improved at least 1 grade in wall motion score.
Results: Out of 93 segments with impaired wall motion, 29 segments showed regional recovery after steroid therapy. In segments with functional recovery, focal FDG uptake was observed in 27 of 29 segments, while it was observed in 40 of 64 segments of segments without functional recovery (p = 0.002). Compared with segments showing functional improvement, those that failed to recover had lower peak radial (16 ± 11 % vs. 24 ± 12 %; p = 0.004), circumferential (-10 ± 6 % vs. -18 ± 5 %; p < 0.001) and longitudinal (-12 ± 5 % vs. -15 ± 5 %; p = 0.017) strain, respectively. Among strain parameters, circumferential strain yielded greater area under the curve (AUC) (0.83) than radial and longitudinal strain (0.74 and 0.71, respectively). A peak circumferential strain < -14.7% had a sensitivity of 80% and a specificity of 76% to predict segmental functional recovery. If meeting the requirements both of FDG uptake and peak circumferential strain <-14.3%, the positive and negative predictive value to predict regional functional recovery were 82% and 90%.
Conclusions: Combination of FDG-PET and 2DSTE can be useful to predict the reversible myocardial segments after steroid therapy in CS.
- © 2013 by American Heart Association, Inc.