TY - JOUR
T1 - Reduced 18F-FDG uptake in the basal interventricular septum as a predictor of fatal ventricular arrhythmic events in patients with cardiac sarcoidosis
AU - Takeuchi, Kouki
AU - Suzuki, Hideaki
AU - Takanami, Kentaro
AU - Ota, Hideki
AU - Tanaka, Yoshitaka
AU - Fujishima, Fumiyoshi
AU - Watanabe, Hirofumi
AU - Susukita, Kai
AU - Inoue, Takumi
AU - Arai, Marina
AU - Hayashi, Hideka
AU - Nochioka, Kotaro
AU - Takahama, Hiroyuki
AU - Suzuki, Takashi
AU - Takase, Kei
AU - Yasuda, Satoshi
N1 - Publisher Copyright:
© 2024
PY - 2025/1/15
Y1 - 2025/1/15
N2 - Background: Patients with cardiac sarcoidosis (CS) are at an increased risk of fatal ventricular arrhythmic events (FVAE). However, the predictive value of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in assessing the risk of FVAE in patients with CS remains uncertain. Methods: We included data from 121 patients with CS (39 men and 82 women; mean age: 59.5 years) who underwent FDG-PET imaging between March 2008 and November 2020, with follow-ups completed in July 2023. Of these, 82 patients had available cardiac magnetic resonance imaging data, including late gadolinium enhancement (LGE). FDG-PET images were analysed using a polar-map model to determine the regional mean percentage uptake relative to the maximal cardiac 18F-FDG uptake in each of the 17 segments defined by the American Heart Association. Results: Patients experiencing FVAE after FDG-PET (n = 43) showed lower percent uptake in the basal inferoseptal segment compared to those who did not (n = 78) (41.8 ± 15.2 % vs. 54.4 ± 13.8 %, P < 0.001). Patients with a basal inferoseptal percent uptake below the median had a lower FVAE-free survival rate than those with a higher percent uptake (58.1 % vs. 78 % at 5 years, P = 0.007), which was consistent in patients with LGE in the same regions with reduced 18F-FDG uptake. A Cox hazard model indicated that the FVAE risk decreased with a hazard ratio of 0.862 (95 % CI 0.770–0.964) for every 5 % increase in basal inferoseptal percent uptake (P = 0.009). Conclusion: Reduced 18F-FDG uptake in the basal interventricular septum, including the inferoseptal segment, may be a valuable predictor of future FVAE in patients with CS.
AB - Background: Patients with cardiac sarcoidosis (CS) are at an increased risk of fatal ventricular arrhythmic events (FVAE). However, the predictive value of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in assessing the risk of FVAE in patients with CS remains uncertain. Methods: We included data from 121 patients with CS (39 men and 82 women; mean age: 59.5 years) who underwent FDG-PET imaging between March 2008 and November 2020, with follow-ups completed in July 2023. Of these, 82 patients had available cardiac magnetic resonance imaging data, including late gadolinium enhancement (LGE). FDG-PET images were analysed using a polar-map model to determine the regional mean percentage uptake relative to the maximal cardiac 18F-FDG uptake in each of the 17 segments defined by the American Heart Association. Results: Patients experiencing FVAE after FDG-PET (n = 43) showed lower percent uptake in the basal inferoseptal segment compared to those who did not (n = 78) (41.8 ± 15.2 % vs. 54.4 ± 13.8 %, P < 0.001). Patients with a basal inferoseptal percent uptake below the median had a lower FVAE-free survival rate than those with a higher percent uptake (58.1 % vs. 78 % at 5 years, P = 0.007), which was consistent in patients with LGE in the same regions with reduced 18F-FDG uptake. A Cox hazard model indicated that the FVAE risk decreased with a hazard ratio of 0.862 (95 % CI 0.770–0.964) for every 5 % increase in basal inferoseptal percent uptake (P = 0.009). Conclusion: Reduced 18F-FDG uptake in the basal interventricular septum, including the inferoseptal segment, may be a valuable predictor of future FVAE in patients with CS.
KW - Cardiac magnetic resonance
KW - Cardiac sarcoidosis
KW - FDG-PET
KW - Fatal ventricular arrhythmic events
KW - Late gadolinium enhancement
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U2 - 10.1016/j.ijcard.2024.132686
DO - 10.1016/j.ijcard.2024.132686
M3 - Article
C2 - 39490748
AN - SCOPUS:85207880720
SN - 0167-5273
VL - 419
JO - International Journal of Cardiology
JF - International Journal of Cardiology
M1 - 132686
ER -