Delayed contrast-enhanced MRI detected myocardial hyperenhancement in 90.9% of patients with cardiac sarcoidosis versus 0% without, predominantly localized in basal and subepicardial layers.
Observational (n=40)
Does delayed contrast-enhanced MRI identify specific topographic localization of myocardial lesions and correlate with LV dysfunction and BNP levels in patients with cardiac sarcoidosis?
Delayed contrast-enhanced MRI reveals that myocardial lesions in cardiac sarcoidosis predominantly localize to the basal and subepicardial myocardium, and their extent correlates with LV dysfunction and BNP levels.
Absolute Event Rate: 90.9% vs 0%
OBJECTIVE: The objective of our study was to use MRI to analyze the topographic localization of myocardial lesions and their relationship to plasma brain natriuretic peptide (BNP) levels and several cardiac function parameters in patients with cardiac sarcoidosis. MATERIALS AND METHODS: Delayed contrast-enhanced MRI was performed in 40 patients with sarcoidosis (11 cardiac, 29 extracardiac cases). Using a 29-segment model of the left ventricle (LV), the extent of myocardial hyperenhancement was visually scored (0 = no hyperenhancement, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, 4 = 76-100% hyperenhancement) and was compared with plasma BNP level and several parameters of cardiac function. RESULTS: Ten of the 11 patients with cardiac sarcoidosis showed myocardial hyperenhancement, whereas none of the 29 patients without cardiac sarcoidosis did. In patients with cardiac sarcoidosis, hyperenhancement was significantly more extensive in basal short axis slices than in apical short axis slices (p < 0.0005). Myocardial hyperenhancement was significantly more frequent in subepicardial layers than in subendocardial layers. The global extent of myocardial hyperenhancement was significantly correlated with plasma BNP levels and the LV end-diastolic volume index and was negatively correlated with the LV ejection fraction. CONCLUSION: In patients with cardiac sarcoidosis, myocardial lesions detected on delayed contrast-enhanced MRI were predominantly localized in the basal and subepicardial myocardium. The extent of myocardial lesions may be related to LV dysfunction and plasma BNP level in patients with cardiac sarcoidosis.
Ichinose et al. (Wed,) conducted a observational in Cardiac sarcoidosis (n=40). Delayed contrast-enhanced MRI vs. Patients with extracardiac sarcoidosis was evaluated on Presence of myocardial hyperenhancement. Delayed contrast-enhanced MRI detected myocardial hyperenhancement in 90.9% of patients with cardiac sarcoidosis versus 0% without, predominantly localized in basal and subepicardial layers.
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