Multimodality assessment of cardiac sarcoidosis to improve diagnostic strategy

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K16127
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: University of Tsukuba
• Principal Investigator: Kimi Sato 筑波大学, 医学医療系, 助教 (30823679)
• Project Period (FY): 2022-04-01 – 2024-03-31
• Keywords: 心臓サルコイドーシス / 心臓MRI / FDG-PET

Outline of Final Research Achievements

Sarcoidosis is a multi-system disorder and cardiac involvement is associated with development of fatal ventricular arrhythmia and left ventricular dysfunction, which lead to severe heart failure or death. Detection of cardiac sarcoidosis (CS) is challenging due to the limited sensitivity of endomyocardial biopsy and the lack of applicable guidelines, especially in patients without extracardiac involvement or isolated CS. We evaluated the characteristics of CS using multimodality imaging evaluation such as CMR, FDG-PET CT, and echocardiography. Patients who diagnosed with isolated CS showed worse outcome than those with other organ involvement and associated with worse left ventricular function and lower SUVmax on FDG-PET. Furthermore, patients who developed fatal ventricular arrhythmia were associated with late gadolinium enhancement on CMR and FDG accumulation on FDG-PET predominant to right ventricle.

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

心臓サルコイドーシスは、致死性不整脈や左室機能障害により重症心不全をきたす予後不良な疾患である。感度の高い疾患特異的な診断指標が存在しないため、早期診断や積極的治療介入が必要なリスクの高い症例の診断が課題となっている。今回の研究により、心臓MRI、PET検査、心エコーなどの画像指標を統合的に評価することにより、不整脈リスクが高い予後が不良な症例の層別化が可能となることが示唆された。