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Utility of cardiac magnetic resonance imaging to differentiate cardiac sarcoidosis from arrhythmogenic right ventricular cardiomyopathy.
Am J Cardiol. 2012 Aug 15; 110(4):575-9.AJ

Abstract

Some patients diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC) are eventually found to have cardiac sarcoidosis (CS). Accurate differentiation between these 2 conditions has implications for immunosuppressive therapy and familial screening. We sought to determine whether cardiac magnetic resonance imaging (MRI) could be used to identify the characteristic findings to accurately differentiate between CS and ARVC. Consecutive patients with a diagnostic MRI scan indicating CS and/or ARVC constituted the cohort. All patients diagnosed with CS had histologic confirmation of sarcoidosis, and all patients with ARVC met the diagnostic task force criteria. The cardiac MRI data were retrospectively analyzed to identify possible differentiating characteristics. Of the patients, 40 had CS and 21 had ARVC. Those with CS were older and had more left ventricular scar. The presence of mediastinal lymphadenopathy or left ventricular septal involvement was seen exclusively in the patients with CS (p <0.001). A family history of sudden cardiac death was seen only in the ARVC group (p = 0.012). The right ventricular ejection fraction and ventricular volumes were also significantly different between the 2 groups. In conclusion, patients with CS have significantly different cardiac MRI characteristics than patients with ARVC. The cardiac volume, in addition to the degree and location of cardiac involvement, can be used to distinguish between these 2 disease entities. The presence of mediastinal lymphadenopathy and left ventricular septal scar favors a diagnosis of CS and not ARVC. Consideration of CS should be given if these MRI findings are observed during the evaluation for possible ARVC.

Authors+Show Affiliations

Section of Cardiac Electrophysiology, University of Colorado, Denver, Colorado, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22595349

Citation

Steckman, David A., et al. "Utility of Cardiac Magnetic Resonance Imaging to Differentiate Cardiac Sarcoidosis From Arrhythmogenic Right Ventricular Cardiomyopathy." The American Journal of Cardiology, vol. 110, no. 4, 2012, pp. 575-9.
Steckman DA, Schneider PM, Schuller JL, et al. Utility of cardiac magnetic resonance imaging to differentiate cardiac sarcoidosis from arrhythmogenic right ventricular cardiomyopathy. Am J Cardiol. 2012;110(4):575-9.
Steckman, D. A., Schneider, P. M., Schuller, J. L., Aleong, R. G., Nguyen, D. T., Sinagra, G., Vitrella, G., Brun, F., Cova, M. A., Pagnan, L., Mestroni, L., Varosy, P. D., & Sauer, W. H. (2012). Utility of cardiac magnetic resonance imaging to differentiate cardiac sarcoidosis from arrhythmogenic right ventricular cardiomyopathy. The American Journal of Cardiology, 110(4), 575-9. https://doi.org/10.1016/j.amjcard.2012.04.029
Steckman DA, et al. Utility of Cardiac Magnetic Resonance Imaging to Differentiate Cardiac Sarcoidosis From Arrhythmogenic Right Ventricular Cardiomyopathy. Am J Cardiol. 2012 Aug 15;110(4):575-9. PubMed PMID: 22595349.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of cardiac magnetic resonance imaging to differentiate cardiac sarcoidosis from arrhythmogenic right ventricular cardiomyopathy. AU - Steckman,David A, AU - Schneider,Preston M, AU - Schuller,Joseph L, AU - Aleong,Ryan G, AU - Nguyen,Duy T, AU - Sinagra,Gianfranco, AU - Vitrella,Giancarlo, AU - Brun,Francesca, AU - Cova,Maria A, AU - Pagnan,Lorenzo, AU - Mestroni,Luisa, AU - Varosy,Paul D, AU - Sauer,William H, Y1 - 2012/05/16/ PY - 2012/01/16/received PY - 2012/04/08/revised PY - 2012/04/08/accepted PY - 2012/5/19/entrez PY - 2012/5/19/pubmed PY - 2012/12/10/medline SP - 575 EP - 9 JF - The American journal of cardiology JO - Am J Cardiol VL - 110 IS - 4 N2 - Some patients diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC) are eventually found to have cardiac sarcoidosis (CS). Accurate differentiation between these 2 conditions has implications for immunosuppressive therapy and familial screening. We sought to determine whether cardiac magnetic resonance imaging (MRI) could be used to identify the characteristic findings to accurately differentiate between CS and ARVC. Consecutive patients with a diagnostic MRI scan indicating CS and/or ARVC constituted the cohort. All patients diagnosed with CS had histologic confirmation of sarcoidosis, and all patients with ARVC met the diagnostic task force criteria. The cardiac MRI data were retrospectively analyzed to identify possible differentiating characteristics. Of the patients, 40 had CS and 21 had ARVC. Those with CS were older and had more left ventricular scar. The presence of mediastinal lymphadenopathy or left ventricular septal involvement was seen exclusively in the patients with CS (p <0.001). A family history of sudden cardiac death was seen only in the ARVC group (p = 0.012). The right ventricular ejection fraction and ventricular volumes were also significantly different between the 2 groups. In conclusion, patients with CS have significantly different cardiac MRI characteristics than patients with ARVC. The cardiac volume, in addition to the degree and location of cardiac involvement, can be used to distinguish between these 2 disease entities. The presence of mediastinal lymphadenopathy and left ventricular septal scar favors a diagnosis of CS and not ARVC. Consideration of CS should be given if these MRI findings are observed during the evaluation for possible ARVC. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/22595349/Utility_of_cardiac_magnetic_resonance_imaging_to_differentiate_cardiac_sarcoidosis_from_arrhythmogenic_right_ventricular_cardiomyopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(12)01189-7 DB - PRIME DP - Unbound Medicine ER -