Scientific Publications Database

Article Title: How common is isolated cardiac sarcoidosis? Extra-cardiac and cardiac findings on clinical examination and whole-body F-18-fluorodeoxyglucose positron emission tomography
Authors: Juneau, Daniel; Nery, Pablo; Russo, Juan; de Kemp, Robert A.; Leung, Eugene; Beanlands, Rob S. B.; Birnie, David H.
Journal: INTERNATIONAL JOURNAL OF CARDIOLOGY Volume 253
Date of Publication:2018
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 F-18-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 +/- 8 years, 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. (c) 2017 Elsevier B.V. All rights reserved.