title: Late gadolinium enhancement in cardiac sarcoidosis: characteristic magnetic resonance findings and relationship with left ventricular function.
abstract: OBJECTIVE
  Cardiac involvement is an important prognostic factor in sarcoidosis, and cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) can facilitate the identification of cardiac sarcoidosis (CS). In patients with CS, we investigated LGE characteristics and their relationship with left ventricular (LV) function to identify those characteristics unique to severely reduced LV function. We also investigated the relationship between LGE and duration of sarcoidosis.
  
  
  METHODS
  We retrospectively evaluated 19 patients with CS diagnosed according to the 2006 revised guidelines of the Japanese Ministry of Health and Welfare who underwent CMR imaging. We analyzed LGE location using 17-segment and subsegment (subepicardial, midwall, subendocardial, and transmural) models and evaluated the relationship between the characteristics of LGE and LV ejection fraction (LVEF) and duration of sarcoidosis.
  
  
  RESULTS
  Images of 17 of the 19 patients showed LGE most frequently in the subepicardial layer. The total number of affected segments with LGE correlated significantly with LVEF (r=-0.84, P<0.0001) and LV-diastolic volumes (r=0.88, P<0.0001). Transmural lesions were significantly more common in patients with LVEF of 35% or lower than in those with LVEF exceeding 35% (P=0.0004). All patients with LVEF of 35% or lower had both subepicardial and transmural lesions. The total number of affected segments with LGE correlated with the duration of sarcoidosis in patients with onset in an extracardiac organ (r=0.76, P=0.005).
  
  
  CONCLUSIONS
  Demonstration of a characteristic LGE pattern and location allows diagnosis of CS, and CMR imaging with LGE aids in prediction of LV function.
authors.affiliation: Department of Cardiology, Institute of Geriatrics, Tokyo Women’s Medical University, 2-15-1 Shibuya, Shibuya-ku, Tokyo 150-0002, Japan. ewatanab@bc4.so-net.ne.jp
authors.forename: Eri
authors.initials: E
authors.lastname: Watanabe
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kimura
authors.forename: Takatomo
authors.initials: T
authors.lastname: Nakajima
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hiroe
authors.forename: Yufuko
authors.initials: Y
authors.lastname: Kasai
authors.forename: Makoto
authors.initials: M
authors.lastname: Nagata
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kawana
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
mesh_terms: D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*
chemical_list: D003287:Contrast Media; D005682:Gadolinium