Washington University in St. Louis School of Medicine, Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, 510 S. Kingshighway Boulevard, Campus Box 8223, St. Louis, MO, 63110, USA.
University Hospitals of Strasbourg, Biophysics and Nuclear Medicine, Strasbourg, 67000, France.
Curr Cardiol Rep. 2024 Jul;26(7):717-722. doi: 10.1007/s11886-024-02070-1. Epub 2024 May 22.
Cardiac involvement in systemic sarcoidosis or isolated cardiac sarcoidosis plays a pivotal role in the clinical manifestation and prognostication. Active-inflammatory cardiac sarcoidosis is associated with a regional impairment of coronary microvascular function that may confer further detrimental effects on myocardial function needing further characterization.
Clinical investigations with cardiac positron emission tomography/computed tomography in conjunction with F-fluorodeoxyglucose to determine myocardial inflammation and N-ammonia to quantify myocardial blood flow (MBF) in patients with known or suspected cardiac sarcoidosis outlined that sarcoidosis-induced myocardial inflammation was associated with adverse effects on corresponding regional coronary microvascular function. Notably, immune-suppressive treatment caused reductions in myocardial inflammation were paralleled by improvements of coronary microvascular dysfunction outlining direct adverse effect of inflammation on coronary arteriolar function. This review summarizes contributions of cardiac PET imaging in the identification and characterization of active-inflammatory cardiac sarcoidosis, its effect on coronary microvascular function, treatment responses, and prognostic implications.
系统性肉样瘤病或孤立性心脏肉样瘤病的心脏受累在临床表现和预后中起着关键作用。活动性炎症性心脏肉样瘤病与冠状动脉微血管功能的区域性损害有关，这可能对心肌功能产生进一步的不利影响，需要进一步的特征描述。
在已知或疑似心脏肉样瘤病患者中，联合 F-氟脱氧葡萄糖进行心脏正电子发射断层扫描/计算机断层扫描以确定心肌炎症，并用 N-氨来量化心肌血流（MBF）的临床研究表明，肉样瘤病引起的心肌炎症与相应的区域性冠状动脉微血管功能障碍的不良影响有关。值得注意的是，免疫抑制治疗引起的心肌炎症减少与冠状动脉微血管功能障碍的改善平行，这表明炎症对冠状动脉小动脉功能有直接的不利影响。本综述总结了心脏 PET 成像在识别和特征描述活动性炎症性心脏肉样瘤病、其对冠状动脉微血管功能的影响、治疗反应和预后意义方面的作用。
