Utility of gallium-67 scintigraphy for evaluation of cardiac sarcoidosis with ventricular tachycardia
Utility of gallium-67 scintigraphy for evaluation of cardiac sarcoidosis with ventricular tachycardia
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DOI：
10.1007/s10554-005-9043-x
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发表时间：
2006-06-01
影响因子：
2.1
通讯作者：
Isobe, Mitsuaki
中科院分区：
文献类型：
--
作者：
Futamatsu, Hideki;Suzuki, Jun-Ichi;Isobe, Mitsuaki
背景：心脏结节病的预后有时很差。与心脏结节病相关的室性心动过速(VT)是大多数患者猝死的最常见原因。然而，对于心脏结节病患者潜在的室性心动过速尚无确定的方法。因此，我们研究了在心脏结节病患者中进行镓-67放射性核素显像评估潜在室速的价值。方法和结果：1982-2004年间，我们或合作医院共诊断了25例心脏结节病患者。其中21例患者接受了皮质类固醇治疗，这些患者根据是否存在室速被分为两组：非室速组(n=7)和室速组(n=14)。检查两组的实验室检查和镓-67放射性核素扫描结果。在随访期内，两组之间皮质类固醇的初始剂量和维持剂量没有显著差异。确诊时室速组的心脏中镓-67蓄积的发生率高于非室速组(14.3%比71.4%，p<；0.05)。在接受随访检查的7名室性心动过速患者中，有6名患者在治疗后的闪烁图上显示出改善。6例患者中有5例在动态心电图、电生理学检查或植入性心律转复除颤器电击方面未见室速复发。两组大多数患者的血清血管紧张素转换酶和溶菌酶浓度均在正常范围内。结论：结节样肉芽肿的活动性可能与室速的发生有关。镓-67核素显像反映了结节样肉芽肿的活动性，因此有助于评估潜在室速患者的心脏结节病。
Background: The outcome of cardiac sarcoidosis is sometimes very poor. Ventricular tachycardia (VT) associated with cardiac sarcoidosis is the most common cause of sudden death among most patients. However, there is no established method for potential VT in patients with cardiac sarcoidosis. Thus, we investigated the utility of evaluation of gallium-67 scintigraphy for potential VT in patients with cardiac sarcoidosis. Methods and Results: Cardiac sarcoidosis was diagnosed in 25 patients at ours or collaborating hospitals during the period 1982 through 2004. Twenty-one of these patients were treated with corticosteroid, and these patients were divided into two groups, depending on whether VT was present: a non-VT group (n=7) and a VT group (n=14). Laboratory and gallium-67 scintigraphy findings were examined in both groups. During the follow-up period, initial and maintenance dosages of corticosteroid did not differ significantly between the groups. Accumulation of gallium-67 in the heart at the time of diagnosis was detected more frequently in the VT group than in the non-VT group (14.3 vs. 71.4%, p < 0.05). Six of the seven VT patients who underwent follow-up examination showed improvement on the scintigram obtained after treatment. Five of the six showed no VT recurrence in terms of Holter electrocardiogram, electrophysiologic study, or delivery of implantable cardioverter defibrillator shock. Serum angiotensin-converting enzyme and lysozyme concentrations were within normal limits in most patients in both groups. Conclusions: Activity of sarcoid granulomas may be associated with the occurrence of VT. Gallium-67 scintigraphy reflects the activity of sarcoid granulomas and thus is useful for evaluation of cardiac sarcoidosis in patients with potential VT.