title: Comprehensive Cardiovascular Magnetic Resonance Assessment in Patients With Sarcoidosis and Preserved Left Ventricular Ejection Fraction.
abstract: BACKGROUND
  Cardiac sarcoidosis (CS) may manifest as arrhythmia or even sudden cardiac death. Because patients with CS often present with nonspecific symptoms, normal electrocardiography, and preserved left ventricular ejection fraction, a reliable diagnostic tool for the work-up of CS is needed. Late gadolinium enhancement-cardiovascular magnetic resonance has proven diagnostic value in CS but has some limitations that may be overcome by adding newer cardiovascular magnetic resonance mapping techniques. The aim of our study was to evaluate a comprehensive cardiovascular magnetic resonance protocol, including late gadolinium enhancement and mapping sequences in sarcoid patients with no symptoms or unspecific symptoms and preserved left ventricular ejection fraction.
  
  
  RESULTS
  Sixty-one sarcoid patients were prospectively enrolled and underwent comprehensive cardiovascular magnetic resonance imaging. Twenty-six healthy volunteers served as control group. Mean left ventricular ejection fraction was 65%; late gadolinium enhancement was only present in sarcoid patients (n=15). Sarcoid patients had a higher median native T1 (994 versus 960 ms; P<0.001), lower post contrast T1 (491 versus 526 ms; P=0.001), expanded extracellular volume (28 versus 25%; P=0.001), and higher T2 values (52 versus 49 ms; P<0.001) compared with controls. Among patients with values higher than the 95% percentile of healthy controls, most significant differences were observed for native T1 and T2 values. Most of these patients were late gadolinium enhancement negative.
  
  
  CONCLUSIONS
  Patients with sarcoidosis demonstrate higher T1, extracellular volume, and T2 values compared with healthy controls, with most significant differences for native T1 and T2. While promising, the clinical significance of the newer mapping techniques with respect to early diagnosis and therapy of CS will have to be determined in future studies.
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Simon
authors.initials: S
authors.lastname: Greulich
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Kitterer
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Joerg
authors.initials: J
authors.lastname: Latus
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Eissa
authors.initials: E
authors.lastname: Aguor
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Hannah
authors.initials: H
authors.lastname: Steubing
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Philipp
authors.initials: P
authors.lastname: Kaesemann
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Alexandru
authors.initials: A
authors.lastname: Patrascu
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Andreas
authors.initials: A
authors.lastname: Greiser
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Stefan
authors.initials: S
authors.lastname: Groeninger
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Agnes
authors.initials: A
authors.lastname: Mayr
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Niko
authors.initials: N
authors.lastname: Braun
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: M Dominik
authors.initials: MD
authors.lastname: Alscher
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.).
authors.forename: Udo
authors.initials: U
authors.lastname: Sechtem
authors.affiliation: From the Division of Cardiology (S.G., H.S., P.K., A.P., U.S., H.M.) and Division of Nephrology, Department of Internal Medicine (D.K., J.L., N.B., M.D.A.), Robert-Bosch-Medical Center Stuttgart, Germany; Philips Medical Solutions, Best, The Netherlands (E.A.); Siemens Healthcare GmbH, Erlangen, Germany (A.G., S.G.); and Division of Radiology, University Hospital Innsbruck, Austria (A.M.). Heiko.Mahrholdt@rbk.de.
authors.forename: Heiko
authors.initials: H
authors.lastname: Mahrholdt
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D003287:Contrast Media / Q000008:administration & dosage; D042241:Early Diagnosis; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D005858:Germany; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA
keywords: cardiomyopathies; early diagnosis; gadolinium; healthy volunteers; sarcoidosis