所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||Detection of undiagnosed cardiac sarcoidosis by FDG-PET and SPECT among patients with atrioventricular block followed in a pacemaker outpatient clinic|
|会議名||The 21st Annual Scientific Meeting of the Japanese Heart Failure Society|
|主催者||Japanese Heart Failure Society|
|発表者・共同発表者||◎OGAWA Risa, SERIZAWA Naoki, FUKUSHIMA Kenji, MOMOSE Mitsuru, SHIGA Tsuyoshi, HAGIWARA Nobuhisa|
|学会抄録||Journal of Cardiac Failure 23(10),S71 2017|
|概要||Background: Atrioventricular block (AVB) is a common initial manifestation of cardiac sarcoidosis (CS) and classified as a major finding of CS. Previous paper reported that 19% of patients with AVB were undiagnosed CS. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) plays an important role in the detection of CS because of high sensitivity.
Methods: We prospectively examined patients with pacemaker implantation for AVB without known cardiac disease in a pacemaker outpatient clinic. Patients with left ventricular ejection fraction (LVEF) < 50% underwent FDG-PET and TL-BMIPP dual single photon emission computed tomography (SPECT) for diagnosing CS. SUVmax in the entire myocardium was obtained from FDG-PET as a marker of disease activity. Newly diagnosed CS patients underwent serial FDG-PET and SPECT after corticosteroid therapy.
Results: Seventeen of 139 enrolled patients (13%) had LVEF < 50%. Three out of 13 patients (23%) were newly diagnosed as CS. Patients with CS had significantly higher SUVmax, BMIPP defect score and TL-BMIPP mismatch score than those without (5.5 ± 1.5 vs 1.8 ± 0.6, P < .001 and 14 ± 3 vs 4 ± 2, P = .010 and 8 ± 4 vs 1 ± 1, P = .001, respectively). In the 3 newly diagnosed CS patients, SUVmax, BMIPP defect score and Tl-BMIPP mismatch score were decreased after corticosteroid treatment.
Conclusions: CS was not uncommon among patients with AVB and reduced LVEF routinely followed in a pacemaker clinic. FDG-PET and SPECT were useful for detecting undiagnosed CS and therapeutic monitoring of those patients.