Evaluation and Management of Cardiac Sarcoidosis with Advanced Imaging

Heart Fail Clin. 2023 Oct;19(4):475-489. doi: 10.1016/j.hfc.2023.06.002. Epub 2023 Jul 23.

Abstract

A high clinical suspicion in the setting of appropriate history, physical exam, laboratory, and imaging parameters is often required to set the groundwork for diagnosis and management. Echocardiography may show septal thinning, evidence of systolic and diastolic dysfunction, along with impaired global longitudinal strain. Cardiac MRI reveals late gadolinium enhancement along with evidence of myocardial edema and inflammation on T2 weighted imaging and parametric mapping. 18F-FDG PET detects the presence of active inflammation and the presence of scar. Involvement of the right ventricle on MRI or PET confers a high risk for adverse cardiac events and mortality.

Keywords: 18F-FDG PET; Cardiac magnetic resonance imaging (MRI); Cardiac sarcoidosis; Echocardiography; Late gadolinium enhancement (LGE); Single-photon emission computerized tomography (SPECT).

Publication types

  • Review

MeSH terms

  • Contrast Media*
  • Echocardiography
  • Gadolinium
  • Humans
  • Inflammation
  • Sarcoidosis* / diagnostic imaging
  • Sarcoidosis* / therapy

Substances

  • Contrast Media
  • Gadolinium