Utility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block
Abstract Diagnosing cardiac sarcoidosis (CS), especially in isolated cases, is challenging, particularly due to the limitations of endomyocardial biopsy, leading to potential undiagnosed cases in pacemaker-implanted patients. This study aims to provide real world findings to support new guideline fo...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-04-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-58475-z |
| _version_ | 1827291578873413632 |
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| author | Subaru Tanabe Yusuke Nakano Hirohiko Ando Masanobu Fujimoto Tomohiro Onishi Hirofumi Ohashi Shimpei Kuno Kazuhiro Naito Katsuhisa Waseda Hiroshi Takahashi Yasushi Suzuki Motoyuki Fukuta Tetsuya Amano |
| author_facet | Subaru Tanabe Yusuke Nakano Hirohiko Ando Masanobu Fujimoto Tomohiro Onishi Hirofumi Ohashi Shimpei Kuno Kazuhiro Naito Katsuhisa Waseda Hiroshi Takahashi Yasushi Suzuki Motoyuki Fukuta Tetsuya Amano |
| author_sort | Subaru Tanabe |
| collection | DOAJ |
| description | Abstract Diagnosing cardiac sarcoidosis (CS), especially in isolated cases, is challenging, particularly due to the limitations of endomyocardial biopsy, leading to potential undiagnosed cases in pacemaker-implanted patients. This study aims to provide real world findings to support new guideline for CS using 18F-fluoro-deoxyglucose positron-emission tomography computed tomography (FDG-PET/CT) which give a definite diagnosis of isolated CS (iCS) without histological findings. We examined consecutive patients with cardiac pacemakers for atrioventricular block (AV-b) attending our outpatient pacemaker clinic. The patients underwent periodical follow-up echocardiography and were divided into two groups according to echocardiographic findings: those with suspected CS and those without suspected CS. Patients suspected of having nonischemic cardiomyopathy underwent FDG-PET/CT for CS diagnosis. We investigated the utility of the new guideline for CS using FDG-PET/CT. Among the 272 patients enrolled, 97 patients were implanted with cardiac pacemakers for AV-b. Twenty-two patients were suspected of having CS during a median observation period of 5.4 years after pacemaker implantation. Of these, one did not consent, and nine of 21 cases (43%) were diagnosed with definite CS according to the new guidelines. Five of these nine patients were diagnosed with iCS using FDG-PET/CT. The number of patients diagnosed with definite CS using the new guidelines tended to be approximately 2.3 times that of the conventional criteria (p = 0.074). Three of the nine patients underwent steroid treatment. The composite outcome, comprising all-cause death, heart failure hospitalization, and a substantial reduction in left ventricular ejection fraction, were significantly lower in patients receiving steroid treatment compared to those without steroid treatment (p = 0.048). The utilization of FDG-PET/CT in accordance with the new guidelines facilitates the diagnosis of CS, including iCS, resulting in approximately 2.3 times as many diagnoses of CS compared to the conventional criteria. This guideline has the potential to support the early identification of iCS and may contribute to enhancing patient clinical outcomes. |
| first_indexed | 2024-04-24T12:40:25Z |
| format | Article |
| id | doaj.art-580147e59ada4372b2414fd2b823607d |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-24T12:40:25Z |
| publishDate | 2024-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-580147e59ada4372b2414fd2b823607d2024-04-07T11:15:32ZengNature PortfolioScientific Reports2045-23222024-04-0114111110.1038/s41598-024-58475-zUtility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular blockSubaru Tanabe0Yusuke Nakano1Hirohiko Ando2Masanobu Fujimoto3Tomohiro Onishi4Hirofumi Ohashi5Shimpei Kuno6Kazuhiro Naito7Katsuhisa Waseda8Hiroshi Takahashi9Yasushi Suzuki10Motoyuki Fukuta11Tetsuya Amano12Department of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Aichi Medical UniversityFujita Health University School of Medical ScienceDepartment of Cardiology, Aichi Medical UniversityDepartment of Cardiology, Tajimi City HospitalDepartment of Cardiology, Aichi Medical UniversityAbstract Diagnosing cardiac sarcoidosis (CS), especially in isolated cases, is challenging, particularly due to the limitations of endomyocardial biopsy, leading to potential undiagnosed cases in pacemaker-implanted patients. This study aims to provide real world findings to support new guideline for CS using 18F-fluoro-deoxyglucose positron-emission tomography computed tomography (FDG-PET/CT) which give a definite diagnosis of isolated CS (iCS) without histological findings. We examined consecutive patients with cardiac pacemakers for atrioventricular block (AV-b) attending our outpatient pacemaker clinic. The patients underwent periodical follow-up echocardiography and were divided into two groups according to echocardiographic findings: those with suspected CS and those without suspected CS. Patients suspected of having nonischemic cardiomyopathy underwent FDG-PET/CT for CS diagnosis. We investigated the utility of the new guideline for CS using FDG-PET/CT. Among the 272 patients enrolled, 97 patients were implanted with cardiac pacemakers for AV-b. Twenty-two patients were suspected of having CS during a median observation period of 5.4 years after pacemaker implantation. Of these, one did not consent, and nine of 21 cases (43%) were diagnosed with definite CS according to the new guidelines. Five of these nine patients were diagnosed with iCS using FDG-PET/CT. The number of patients diagnosed with definite CS using the new guidelines tended to be approximately 2.3 times that of the conventional criteria (p = 0.074). Three of the nine patients underwent steroid treatment. The composite outcome, comprising all-cause death, heart failure hospitalization, and a substantial reduction in left ventricular ejection fraction, were significantly lower in patients receiving steroid treatment compared to those without steroid treatment (p = 0.048). The utilization of FDG-PET/CT in accordance with the new guidelines facilitates the diagnosis of CS, including iCS, resulting in approximately 2.3 times as many diagnoses of CS compared to the conventional criteria. This guideline has the potential to support the early identification of iCS and may contribute to enhancing patient clinical outcomes.https://doi.org/10.1038/s41598-024-58475-z |
| spellingShingle | Subaru Tanabe Yusuke Nakano Hirohiko Ando Masanobu Fujimoto Tomohiro Onishi Hirofumi Ohashi Shimpei Kuno Kazuhiro Naito Katsuhisa Waseda Hiroshi Takahashi Yasushi Suzuki Motoyuki Fukuta Tetsuya Amano Utility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block Scientific Reports |
| title | Utility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block |
| title_full | Utility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block |
| title_fullStr | Utility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block |
| title_full_unstemmed | Utility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block |
| title_short | Utility of new FDG-PET/CT guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block |
| title_sort | utility of new fdg pet ct guidelines for diagnosing cardiac sarcoidosis in patients with implanted cardiac pacemakers for atrioventricular block |
| url | https://doi.org/10.1038/s41598-024-58475-z |
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