The prognostic role of cardiac positron emission tomography imaging in patients with sarcoidosis: A systematic review

Ahmed, Ahmed Ibrahim; Abebe, Abel Tsehay; Han, Yushui; Alnabelsi, Talal; Agrawal, Tanushree; Kassi, Mahwash; Aljizeeri, Ahmed; Taylor, Amy E; Tleyjeh, Imad M.; Al‐Mallah, Mouaz H.

doi:10.1007/s12350-021-02681-z

Cited by 14 publications

(5 citation statements)

References 24 publications

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“…Retrospective studies in patients with known or suspected CS have shown a prognostic role of abnormal cardiac FGT-PET findings [ 20 , 74 , 75 ]. Nevertheless, it is crucial to note that the quality of available data is relatively low and conflicting results have been reported [ 76 , 77 ].…”

Section: Diagnosismentioning

confidence: 99%

Cardiac Sarcoidosis—Diagnostic and Therapeutic Challenges

Korthals,

Bietenbeck,

Könemann

et al. 2024

JCM

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Sarcoidosis is a multisystem disorder of unknown etiology. The leading hypothesis involves an antigen-triggered dysregulated T-cell-driven immunologic response leading to non-necrotic granulomas. In cardiac sarcoidosis (CS), the inflammatory response can lead to fibrosis, culminating in clinical manifestations such as atrioventricular block and ventricular arrhythmias. Cardiac manifestations frequently present as first and isolated signs or may appear in conjunction with extracardiac manifestations. The incidence of sudden cardiac death (SCD) is high. Diagnosis remains a challenge. For a definite diagnosis, endomyocardial biopsy (EMB) is suggested. In clinical practice, compatible findings in advanced imaging using cardiovascular magnetic resonance (CMR) and/or positron emission tomography (PET) in combination with extracardiac histological proof is considered sufficient. Management revolves around the control of myocardial inflammation by employing immunosuppression. However, data regarding efficacy are merely based on observational evidence. Prevention of SCD is of particular importance and several guidelines provide recommendations regarding device therapy. In patients with manifest CS, outcome data indicate a 5-year survival of around 90% and a 10-year survival in the range of 80%. Data for patients with silent CS are conflicting; some studies suggest an overall benign course of disease while others reported contrasting observations. Future research challenges involve better understanding of the immunologic pathogenesis of the disease for a targeted therapy, improving imaging to aid early diagnosis, assessing the need for screening of asymptomatic patients and randomized trials.

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Section: Diagnosismentioning

confidence: 99%

Cardiac Sarcoidosis—Diagnostic and Therapeutic Challenges

Korthals,

Bietenbeck,

Könemann

et al. 2024

JCM

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“…The prognostic value of PET was confirmed in a recent meta-analysis [124], though not all works are supportive [125,126]. Major challenges in cardiac sarcoidosis remain, particularly the lack of a simple gold standard, the often delayed diagnosis, sampling error when facilitating endomyocardial biopsy, and the potential overlap with other cardiomyopathies that may present a "hot phase", which make the diagnosis often difficult [127][128][129][130].…”

Section: Cardiac Sarcoidosismentioning

confidence: 99%

Positron Emission Tomography in Heart Failure: From Pathophysiology to Clinical Application

Tersalvi

Beltrani

Grübler

et al. 2023

JCDD

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Imaging modalities are increasingly being used to evaluate the underlying pathophysiology of heart failure. Positron emission tomography (PET) is a non-invasive imaging technique that uses radioactive tracers to visualize and measure biological processes in vivo. PET imaging of the heart uses different radiopharmaceuticals to provide information on myocardial metabolism, perfusion, inflammation, fibrosis, and sympathetic nervous system activity, which are all important contributors to the development and progression of heart failure. This narrative review provides an overview of the use of PET imaging in heart failure, highlighting the different PET tracers and modalities, and discussing fields of present and future clinical application.

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“…Initiating immunosuppression for CS presupposes proof of inflammatory activity, and repeat scans may help identify response to and relapse after therapy. 60 , 61 The prognostic value of PET was confirmed in a recent meta-analysis of pertinent studies, 62 though not all works are supportive. 63 , 64 A ‘mismatch pattern’ (see Figure 2 ) and RV uptake are the key predictors of cardiac events.…”

Section: Introductionmentioning

confidence: 99%

“…More research is needed focusing on the risk and predictors of SCD. Quantitative data from analyses of MRI, FDG-PET, and circulating biomarkers may help, 58 , 62 , 63 , 84 , 106 , 158 , 159 and involvement of the right ventricle needs more emphasis. 58 , 65 , 66 , 160 Whether the diagnosis of CS is definite or probable also deserves consideration.…”

Section: Introductionmentioning

confidence: 99%

Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis

Lehtonen

Uusitalo

Pöyhönen

et al. 2023

European Heart Journal

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Cardiac sarcoidosis (CS) results from epithelioid cell granulomas infiltrating the myocardium and predisposing to conduction disturbances, ventricular tachyarrhythmias, and heart failure. Manifest CS, however, constitutes only the top of an iceberg as advanced imaging uncovers cardiac involvement 4 to 5 times more commonly than what is clinically detectable. Definite diagnosis of CS requires myocardial biopsy and histopathology, but a sufficient diagnostic likelihood can be achieved by combining extracardiac histology of sarcoidosis with clinical manifestations and findings on cardiac imaging. CS can appear as the first or only organ manifestation of sarcoidosis or on top of pre-existing extracardiac disease. Due to the lack of controlled trials, the care of CS is based on observational evidence of low quality. Currently, the treatment involves corticosteroid-based, tiered immunosuppression to control myocardial inflammation with medical and device-based therapy for symptomatic atrioventricular block, ventricular tachyarrhythmias, and heart failure. Recent outcome data indicate 90% to 96% 5-year survival in manifest CS with the 10-year figures ranging from 80% to 90%. Major progress in the care of CS awaits the key to its molecular–genetic pathogenesis and large-scale controlled clinical trials.

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The prognostic role of cardiac positron emission tomography imaging in patients with sarcoidosis: A systematic review

Cited by 14 publications

References 24 publications

Cardiac Sarcoidosis—Diagnostic and Therapeutic Challenges

Cardiac Sarcoidosis—Diagnostic and Therapeutic Challenges

Positron Emission Tomography in Heart Failure: From Pathophysiology to Clinical Application

Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis

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