VentriPoint Diagnostics Ltd (VPTDF)

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sarcoidosis
Right ventricular involvement in cardiac sarcoidosis ...
Definitively, we'll be in a very solid position to displace MRI for that condition.

One more study that showed that until today, MRI was THE technology.
Not anymore. ...

Note this special passage:

Until recently, limited attention has been given to right ventricular involvement in cardiac sarcoidosis, its prevalence, relevance, and prognostic value. Cardiac magnetic resonance imaging is the preferred imaging tool to evaluate the healthy and diseased right ventricle.



Right ventricular involvement in cardiac sarcoidosis demonstrated with cardiac magnetic resonance (MRI)

First published: 06 June 2017

Smedema JP1, van Geuns RJ2, Ainslie G3, Ector J4, Heidbuchel H5, Crijns HJGM1.
Author information

1
Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
2
Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
3
Respiratory Clinic, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.
4
Department of Cardiology, University Hospitals Gasthuisberg, Leuven, Belgium.
5
University of Hasselt Heart Centre, Virga Jessa Hospital, Hasselt, Belgium.


Abstract
Aims

Cardiac involvement in sarcoidosis is reported in up to 30% of patients. Left ventricular involvement demonstrated by contrastenhanced cardiac magnetic resonance has been well validated. We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis.
Methods and results

We prospectively evaluated 87 patients diagnosed with pulmonary sarcoidosis with contrastenhanced cardiac magnetic resonance for right ventricular involvement. Pulmonary artery pressures were noninvasively evaluated with Doppler echocardiography. Patient characteristics were compared between the groups with and without right ventricular involvement, and right ventricular enhancement was correlated with pulmonary hypertension, ventricular mass, volume, and systolic function. Left ventricular late gadolinium enhancement was demonstrated in 30 patients (34%). Fourteen patients (16%) had right ventricular late gadolinium enhancement, with sole right ventricular enhancement in only two patients. The pattern of right ventricular enhancement consisted of right ventricular outflow tract enhancement in 1 patient, free wall enhancement in 8 patients, ventricular insertion point enhancement in 10 patients, and enhancement of the right side of the interventricular septum in 11 patients. Pulmonary arterial hypertension correlated with the presence of right ventricular enhancement (P < 0.001). Right ventricular enhancement correlated with systolic ventricular dysfunction (P < 0.001), hypertrophy (P = 0.001), and dilation (P < 0.001).
Conclusions

Right ventricular enhancement was present in 16% of patients diagnosed with pulmonary sarcoidosis and in 48% of patients with left ventricular enhancement. The presence of right ventricular enhancement correlated with pulmonary arterial hypertension, right ventricular systolic dysfunction, hypertrophy, and dilation.
Introduction

Sarcoidosis is a rare, inflammatory condition, resulting from an uncontrolled cellular inflammatory response in genetically predisposed individuals, which affects the heart in approximately a third of patients.1 Left ventricular involvement demonstrated by contrastenhanced cardiac magnetic resonance has been well validated.2 Until recently, limited attention has been given to right ventricular involvement in cardiac sarcoidosis, its prevalence, relevance, and prognostic value.3 Cardiac magnetic resonance imaging is the preferred imaging tool to evaluate the healthy and diseased right ventricle.4, 5 Right ventricular volumes, mass, and function can be quantified without geometric assumptions and excellent intraobserver and interobserver agreement and interstudy reproducibility.4-6 Delayed contrastenhanced magnetic resonance allows for the detection and quantification of focal scar and interstitial fibrosis. Although there are numerous reports on delayed contrastenhanced cardiac magnetic resonance delineating left ventricular sarcoidosis, relatively few studies have reported on right ventricular involvement.3, 7-10 We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis and determine the relationship with pulmonary hypertension, ventricular volume, mass, and systolic function.
Methods
Patient selection

Between July 2001 and March 2014, we enrolled 87 consecutive patients with histologically proven pulmonary sarcoidosis. Cardiac evaluation was performed because of symptoms or routine screening to exclude cardiac involvement. Patients were excluded when the standard contraindications for contrastenhanced cardiac magnetic resonance existed. Institutional Review Board approval was obtained for this study.
Baseline investigations

Baseline investigations included 12lead electrocardiography, Doppler echocardiography, and contrastenhanced cardiac magnetic resonance.
Cardiac magnetic resonance protocol and analysis

Studies were performed using a commercial 1.5 T scanner with a cardiacdedicated phasedarray coil. The cardiac magnetic resonance studies were electrocardiographically triggered by standard software.