Utility of gallium-67 scintigraphy for evaluation of cardiac sarcoidosis with ventricular tachycardia.
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.


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.
Futamatsu
Hideki
H
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan.
Suzuki
Jun-ichi
J
Adachi
Susumu
S
Okada
Hiroyuki
H
Otomo
Kenichiro
K
Ohara
Takahiro
T
Hashimoto
Yuji
Y
Kakuta
Tsunekazu
T
Iesaka
Yoshito
Y
Yamaguchi
Hiroaki
H
Sakurada
Harumizu
H
Sato
Akira
A
Obayashi
Tohru
T
Niwa
Akihiro
A
Hirao
Kenzo
K
Isobe
Mitsuaki
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005069:Evaluation Studies as Topic; D005260:Female; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000889:Anti-Arrhythmia Agents; D000893:Anti-Inflammatory Agents; D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D000638:Amiodarone