Nobuhisa Hagiwara    Department   Other, Other    Position
Language	English
Title	Detection of undiagnosed cardiac sarcoidosis by FDG-PET and SPECT among patients with atrioventricular block followed in a pacemaker outpatient clinic
Conference	The 21st Annual Scientific Meeting of the Japanese Heart Failure Society
Promoters	Japanese Heart Failure Society
Conference Type	Nationwide Conferences
Presentation Type	Poster notice
Lecture Type	General
Publisher and common publisher	◎OGAWA Risa, SERIZAWA Naoki, FUKUSHIMA Kenji, MOMOSE Mitsuru, SHIGA Tsuyoshi, HAGIWARA Nobuhisa
Date	2017/10/12
Venue (city and name of the country)	Akita, JAPAN
Society abstract	Journal of Cardiac Failure 23(10),S71 2017
Summary	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.