Author + information
- Jihaeng Im,
- Naoki Serizawa,
- Kenji Fukushima,
- Yasutaka Imamura,
- Arata Nomura,
- Akiko Sakai,
- Mitsuru Momose,
- Michinobu Nagao,
- Tsuyoshi Shiga,
- Koichiro Abe and
- Nobuhisa Hagiwara
Corticosteroid therapy is recommended for initial treatment for cardiac sarcoidosis (CS). However, optimal maintenance dose and evaluation method for activity of CS are not established. We evaluated the activity of CS by 18F-fluorodeoxyglucose PET (FDG) during maintenance dose period of corticosteroid therapy.
Fifty consecutive patients with CS who underwent FDG before and after corticosteroid therapy were enrolled into analysis. FDG uptake was analyzed quantitatively for each scan and mean/max of standardized uptake in myocardium (SUVmean, SUVmax); cardiac metabolic volume (CMV=volume with SUV>2.5) were measured. All patients were treated with 30 mg/day of prednisolone after diagnosis, which was tapered to a maintenance dose of 5-10 mg/day according to the guideline. If the disease is stable, corticosteroid may be tapered further at a physician's discretion. Patients who have not achieved to maintenance dose of corticosteroid were excluded. Relapse of CS was defined as SUVmax>2.5 with developed myocardial damage evaluated by single photon emission computed tomography or cardiovascular magnetic resonance imaging.
Thirty-nine patients were included (the median minimum dose of corticosteroid was 7.5mg (IQR, 1-10). Five of 39 patients (13%) had the evidence of relapse. Patients with relapsed showed significantly greater CMV at diagnosis (208±93 vs. 78±112 ml, p=0.028) and change in left ventricular ejection fraction (-7±11 vs. 3±6 %, p=0.023) than those without. While, SUVmax, LVEF, and conventional biomarker test, such as ACE and lysozyme at diagnosis, and maintenance dosage of corticosteroid were not significant differences patients with and without relapse. All patients with relapse were handled by increasing prednisone and diminished of FDG uptake at follow-up.
During maintenance dose period of corticosteroid, relapses were not uncommon. FDG-PET should be recommended to evaluate CS activity.
Poster Hall, Hall A/B
Monday, March 12, 2018, 9:45 a.m.-10:30 a.m.
Session Title: What's New in Nuclear Cardiology?
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1294-331
- 2018 American College of Cardiology Foundation