Diagnostic accuracy of cardiac magnetic resonance imaging for cardiac sarcoidosis in complete heart block patients implanted with magnetic resonance-conditional pacemaker.
Cardiac magnetic resonance imaging
Cardiac sarcoidosis
Complete heart block
Magnetic resonance-conditional pacemaker
Journal
Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
15
09
2019
revised:
19
01
2020
accepted:
09
02
2020
pubmed:
19
3
2020
medline:
4
5
2021
entrez:
19
3
2020
Statut:
ppublish
Résumé
Cardiac magnetic resonance (CMR) imaging has become the principal noninvasive imaging modality for the diagnosis of cardiac sarcoidosis (CS) patients. This study aimed to determine the diagnostic performance of CMR imaging for CS in new-onset complete heart block (CHB) patients implanted with magnetic resonance-conditional pacemaker (MRCP). Fifty CHB patients implanted with MRCP were enrolled in this study. Clinical CS was diagnosed if there was a histological diagnosis of extra-cardiac sarcoidosis in patients with CHB based on the consensus statement; clinical CS was the reference standard. The diagnostic performance of CMR sequences, including cine magnetic resonance imaging (MRI), increased T2-weighted signal (T2WS), and late gadolinium enhancement (LGE), for clinical CS was investigated. We also compared the diagnostic performance of CMR sequences between the entire left ventricle (LV) and the basal septum, which involves the electrical pathway of atrioventricular conduction. In total, 8 of the 50 patients with CHB were confirmed to have extra-cardiac sarcoidosis and were diagnosed with clinical CS. The accuracy, sensitivity, and specificity of LGE in the basal septum and entire LV were 94%, 100%, and 93% and 80% (p = 0.023), 100% (p = 1.00), and 76% (p = 0.023), respectively. The accuracy, sensitivity, and specificity of increased T2WS and cine MRI in the basal septum were 94%, 75%, and 98% and 90%, 38%, and 100%, respectively. There was no statistical difference between the entire LV and the basal septum for the diagnostic performance of increased T2WS and cine MRI. CMR can be a diagnostic tool for evaluating clinical CS in patients with CHB implanted with MRCP. LGE in the basal septum might provide the overall best diagnostic performance for clinical CS with CHB.
Sections du résumé
BACKGROUND
Cardiac magnetic resonance (CMR) imaging has become the principal noninvasive imaging modality for the diagnosis of cardiac sarcoidosis (CS) patients. This study aimed to determine the diagnostic performance of CMR imaging for CS in new-onset complete heart block (CHB) patients implanted with magnetic resonance-conditional pacemaker (MRCP).
METHODS
Fifty CHB patients implanted with MRCP were enrolled in this study. Clinical CS was diagnosed if there was a histological diagnosis of extra-cardiac sarcoidosis in patients with CHB based on the consensus statement; clinical CS was the reference standard. The diagnostic performance of CMR sequences, including cine magnetic resonance imaging (MRI), increased T2-weighted signal (T2WS), and late gadolinium enhancement (LGE), for clinical CS was investigated. We also compared the diagnostic performance of CMR sequences between the entire left ventricle (LV) and the basal septum, which involves the electrical pathway of atrioventricular conduction.
RESULTS
In total, 8 of the 50 patients with CHB were confirmed to have extra-cardiac sarcoidosis and were diagnosed with clinical CS. The accuracy, sensitivity, and specificity of LGE in the basal septum and entire LV were 94%, 100%, and 93% and 80% (p = 0.023), 100% (p = 1.00), and 76% (p = 0.023), respectively. The accuracy, sensitivity, and specificity of increased T2WS and cine MRI in the basal septum were 94%, 75%, and 98% and 90%, 38%, and 100%, respectively. There was no statistical difference between the entire LV and the basal septum for the diagnostic performance of increased T2WS and cine MRI.
CONCLUSIONS
CMR can be a diagnostic tool for evaluating clinical CS in patients with CHB implanted with MRCP. LGE in the basal septum might provide the overall best diagnostic performance for clinical CS with CHB.
Identifiants
pubmed: 32184028
pii: S0914-5087(20)30070-8
doi: 10.1016/j.jjcc.2020.02.014
pii:
doi:
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
191-197Informations de copyright
Copyright © 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.