Abstract 20409: Myocardial Flow Reserve Is Impaired In Systemic Sarcoidosis
Introduction: Myocardial inflammation or scarring in patients with cardiac sarcoidosis may be associated with impaired myocardial blood flow (MBF). We sought to investigate MBF and flow reserve (MFR) in patients with sarcoidosis and compare results to controls.
Methods: A single-center retrospective cohort analysis was performed in patients with systemic sarcoidosis and FDG- positron emission tomography (FDG-PET) findings of inflammation or scar without obstructive coronary artery disease (CAD) who underwent dynamic rest-stress (Rb-82 with 0.4mg regadenoson) PET-myocardial perfusion imaging (PET-MPI) from 2007-2015 and compared to controls without CAD or active disease known to be associated with low MBF. 4DM software was used to calculate MBF and MFR in a 17-segment model. Multiple linear regression was used to assess the association between MFR and sarcoidosis after adjusting for age, sex, hypertension, hyperlipidemia, body mass index, diabetes, and ejection fraction.
Results: We identified 16 patients with extra-cardiac sarcoidosis and positive FDG-PET (age 52.6±10.6 years, EF 48.7±14%, JMHW positive 63%) and 31 controls (age 57.7±10.8 years, EF 59.5±10.8%). There were 5 patients with sarcoidosis with low MFR defined as <2 and one patient in the control group. Total rest MBF and MFR were lower in the sarcoidosis patients as compared to controls (Table 1). In a multivariable model after adjusting for confounding variables, sarcoidosis was associated with lower MFR (beta = -0.66, p = 0.001). The decreased MFR persisted after additionally adjusting for rest MBF (beta = -0.41, p = 0.025).
Conclusions: Global MFR is reduced in patients with systemic sarcoidosis as compared to controls after adjusting for confounding variables.
Author Disclosures: B.W. Sperry: None. B.K. Tamarappoo: None. L. Young: None. R. Brunken: None. M. Cerqueira: None. R. Hachamovitch: None.
- © 2016 by American Heart Association, Inc.