Daniel Juneau1, Pablo Nery2, Juan Russo2, Robert A de Kemp2, Eugene Leung3, Rob S B Beanlands2, David H Birnie4. 1. Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Nuclear Medicine, Medical Imaging Department, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada. 2. Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. 3. Division of Nuclear Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. 4. Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address: dbirnie@ottawaheart.ca.
Abstract
BACKGROUND: Sarcoidosis is a systemic inflammatory disease which can involve nearly any organ. Clinically manifest cardiac involvement occurs in perhaps 5% of patients with sarcoidosis. The reported prevalence of isolated cardiac sarcoidosis (CS) varies widely with reported rates of 27-54%. The explanation for this variability is likely multi-factorial but perhaps mostly related to the diagnostic method(s) for assessing extra-cardiac involvement. The primary aim of this study was to assess the rate of isolated CS in a homogeneous, prospectively recruited cohort of patients with clinically manifest CS, using whole body FDG PET-CT imaging as a gold standard. A secondary aim was to describe the extent and distribution of extra-cardiac sarcoidosis at the time of first presentation of clinically manifest CS. METHODS: Patients were prospectively recruited at the time of first presentation with cardiac symptoms. All patients underwent whole-body and cardiac 18F-FDG PET-CT. All patients were examined for presence of skin sarcoidosis and were assessed by an ophthalmologist. RESULTS: 31 patients were included (mean age 56±8years, 17 female, 100% Caucasian). Patients had limited extra-cardiac involvement (mean of 2.2 organs) however using the most precise definition, only 1/31 (3.2%) patients had isolated CS. There were marked differences in right ventricular (RV) and atrial involvement between patients presenting with CS as first presentation compared to patients presenting initially with extra-cardiac disease. CONCLUSIONS: Most patients had limited extra-cardiac involvement at the time of presentation of manifest CS however, isolated CS, using the proposed gold standard, was only observed in one patient.
BACKGROUND:Sarcoidosis is a systemic inflammatory disease which can involve nearly any organ. Clinically manifest cardiac involvement occurs in perhaps 5% of patients with sarcoidosis. The reported prevalence of isolated cardiac sarcoidosis (CS) varies widely with reported rates of 27-54%. The explanation for this variability is likely multi-factorial but perhaps mostly related to the diagnostic method(s) for assessing extra-cardiac involvement. The primary aim of this study was to assess the rate of isolated CS in a homogeneous, prospectively recruited cohort of patients with clinically manifest CS, using whole body FDG PET-CT imaging as a gold standard. A secondary aim was to describe the extent and distribution of extra-cardiac sarcoidosis at the time of first presentation of clinically manifest CS. METHODS:Patients were prospectively recruited at the time of first presentation with cardiac symptoms. All patients underwent whole-body and cardiac 18F-FDG PET-CT. All patients were examined for presence of skin sarcoidosis and were assessed by an ophthalmologist. RESULTS: 31 patients were included (mean age 56±8years, 17 female, 100% Caucasian). Patients had limited extra-cardiac involvement (mean of 2.2 organs) however using the most precise definition, only 1/31 (3.2%) patients had isolated CS. There were marked differences in right ventricular (RV) and atrial involvement between patients presenting with CS as first presentation compared to patients presenting initially with extra-cardiac disease. CONCLUSIONS: Most patients had limited extra-cardiac involvement at the time of presentation of manifest CS however, isolated CS, using the proposed gold standard, was only observed in one patient.
Authors: Stewart D Spence; Maria C Medor; Pablo B Nery; Eva Shepherd-Perkins; Daniel Juneau; Steve Promislow; Alyssa Nikolla; Robert A deKemp; Rob S Beanlands; David H Birnie Journal: CJC Open Date: 2020-07-17
Authors: Maria Giovanna Trivieri; Paolo Spagnolo; David Birnie; Peter Liu; Wonder Drake; Jason C Kovacic; Robert Baughman; Zahi A Fayad; Marc A Judson Journal: J Am Coll Cardiol Date: 2020-10-20 Impact factor: 24.094
Authors: Nisha A Gilotra; Jan M Griffin; Noelle Pavlovic; Brian A Houston; Jessica Chasler; Colleen Goetz; Jonathan Chrispin; Michelle Sharp; Edward K Kasper; Edward S Chen; Ron Blankstein; Leslie T Cooper; Emer Joyce; Farooq H Sheikh Journal: J Card Fail Date: 2021-07-11 Impact factor: 5.712
Authors: John A Belperio; Faisal Shaikh; Fereidoun Abtin; Michael C Fishbein; Rajan Saggar; Edmund Tsui; Joseph P Lynch Journal: EClinicalMedicine Date: 2021-06-27
Authors: Willy Weng; Christiane Wiefels; Santabhanu Chakrabarti; Pablo B Nery; Emel Celiker-Guler; Jeff S Healey; Tomasz W Hruczkowski; F Russell Quinn; Steven Promislow; Maria C Medor; Stewart Spence; Roupen Odabashian; Wael Alqarawi; Daniel Juneau; Rob de Kemp; Eugene Leung; Rob Beanlands; David Birnie Journal: J Am Heart Assoc Date: 2020-08-20 Impact factor: 5.501