Linking cardiac and extracardiac sarcoidosis and their clinical outcome: 18F-FDG PET/CT analysis in patients with systemic cardiac sarcoidosis
Linking cardiac and extracardiac sarcoidosis and their clinical outcome: 18F-FDG PET/CT analysis in patients with systemic cardiac sarcoidosis
复制标题
将心脏和心外结节病及其临床结果联系起来：全身性心脏结节病患者的 18F-FDG PET/CT 分析
DOI：
10.1007/s12149-023-01844-x
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发表时间：
2023
影响因子：
2.6
通讯作者：
Sakai Shuji
中科院分区：
文献类型：
--
作者：
Kaneko Koichiro;Nagao Michinobu;Yamamoto Atsushi;Sakai Akiko;Sakai Shuji
目的通过连续FDG-PET/CT研究阐明系统性CS（SCS）患者中心脏结节病（CS）和CS外结节病（ECS）的程度和临床结局之间的联系。在总体分析中，对CS和ECS病变之间的完全消退（CR）和复发率进行了基于患者的比较。然后，根据ECS的程度（单器官与多器官ECS组）和临床结局（稳定与不稳定ECS组）进行亚组分析。比较单器官和多器官ECS组治疗前心脏FDG摄取。比较两组的CR率、复发率和主要不良心脏事件（MACE），结果CS的CR率显著高于ECS病变[77.1%（27/35）vs. 48.5%（17/35），p = 0.01]，而CS和ECS的复发率相似[40.7%（11/27）vs. 58.8%（10/17）]。单器官和多器官ECS组在治疗前条件下均显示出相似的SUVmax、心脏代谢体积和心脏代谢活性。单器官和多器官ECS组的CR率相似[71.4%（15/21）vs. 85.7%（12/14）]，但多器官ECS组的复发率显著较低[60.0%（9/15）vs. 16.7%（2/12），p = 0.02]。稳定和不稳定ECS组的CR [71.4%（5/7）vs. 78.6%（22/28）]和复发率[60.0%（3/5）vs. 36.3%（8/22）]无显著差异。MACE的发生率在单器官和多器官ECS组之间[19.0%（4/21）vs. 28.6%（4/14）]或在稳定和不稳定ECS组之间[42.9%（3/7）vs. 17.8%（5/28）]也没有显著差异。ECS病变的范围和临床结局与CS病变无关。
ObjectiveTo clarify the link between cardiac sarcoidosis (CS) and extra-CS (ECS) in systemic CS (SCS) patients in terms of extent and clinical outcome by serial FDG-PET/CT.MethodsThirty-five SCS patients treated for > 2 years were enrolled in this study. In the overall analysis, patient-based comparisons of the complete resolution (CR) and recurrence rate between CS and ECS lesions were performed. Then, subgroup analyses were performed according to the extent (mono- vs. multi-organ ECS group) and clinical outcome (stable vs. unstable ECS group) of ECS. Pre-treatment cardiac FDG uptake was compared between the mono- and multi-organ ECS groups. The rates of CR, recurrence, and major adverse cardiac events (MACE) were compared between the two groups.ResultsThe CR rate was significantly higher in CS than ECS lesions [77.1% (27/35) vs. 48.5% (17/35), p = 0.01], whereas recurrence rates were similar between CS and ECS [40.7% (11/27) vs. 58.8% (10/17)]. Both the mono- and multi-organ ECS groups showed similar SUVmax, cardiac metabolic volume, and cardiac metabolic activity in the pre-treatment condition. The CR rates were similar between the mono- and multi-organ ECS groups [71.4% (15/21) vs. 85.7% (12/14)], but the recurrence rate was significantly lower in the multi-organ ECS group [60.0% (9/15) vs. 16.7% (2/12), p = 0.02]. The CR [71.4% (5/7) vs. 78.6% (22/28)] and recurrence rates [60.0% (3/5) vs. 36.3% (8/22)] were not significantly different between the stable and unstable ECS groups. The occurrence of MACE was also not significantly different between the mono- and multi-organ ECS groups [19.0% (4/21) vs. 28.6% (4/14)] or between the stable and unstable ECS groups [42.9% (3/7) vs. 17.8% (5/28)].ConclusionsCS lesions respond to treatment better than ECS lesions, and the extent and clinical outcome of ECS lesion are not linked with those of CS lesions.