PET IMAGING may play a crucial role in identifying patients with cardiac sarcoidosis at higher risk of major adverse cardiac events (MACE), according to a new study. The study’s findings highlight the prognostic value of PET imaging, particularly the use of the fluorodeoxyglucose (FDG) radiotracer, which identifies areas of cardiac inflammation. “This study supports the routine use of FDG-PET in [cardiac sarcoidosis] for risk stratification given that patients who have specific features such as [right ventricular] uptake may be at higher risk of future MACE,” commented the authors.
The research involved a comprehensive meta-analysis of 55 published cardiac PET studies. The analysis included data from 5,250 patients with cardiac sarcoidosis, a condition characterised by the formation of granulomas in the heart tissue, leading to arrhythmias and heart failure.
In their analysis, the researchers found that abnormal FDG uptake and perfusion defect findings were significantly predictive of MACE. Key risk factors identified included abnormal FDG uptake with an odds ratio (OR) of 2.61, abnormal perfusion or FDG uptake (OR, 2.69), and the combination of both (OR = 2.86). These findings suggest that PET imaging can provide vital prognostic information beyond its established diagnostic use.
Despite the promising results, the study acknowledged limitations, including the short duration of follow-up and the small sample sizes in many of the analysed studies. The authors called for longer-term evaluations to determine whether FDG-PET remains prognostic over time.
Overall, the study contributed valuable insights into the role of PET imaging in managing cardiac sarcoidosis, particularly in stratifying patients based on their risk of adverse cardiac events. As research in this area continues to evolve, PET imaging may become an essential tool in the personalised care of patients with this complex condition.
Victoria Antoniou, EMJ
Reference
Kafil TS et al. Risk stratification in cardiac sarcoidosis with cardiac positron emission tomography: a systematic review and meta-analysis. JACC Cardiovasc Imaging. 2024;DOI:10.1016/j.jcmg.2024.05.013.
