セリザワ ナオキ   SERIZAWA Naoki
  芹澤 直紀
   所属   医学部 医学科(東京女子医科大学病院)
   職種   助教
言語種別 英語
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
学会区分 全国規模の学会
発表形式 ポスター掲示
講演区分 一般
発表者・共同発表者◎OGAWA Risa, SERIZAWA Naoki, FUKUSHIMA Kenji, MOMOSE Mitsuru, SHIGA Tsuyoshi, HAGIWARA Nobuhisa
発表年月日 2017/10/12
開催地
(都市, 国名)
Akita, JAPAN
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.