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The role of cardiac magnetic resonance in diagnosis of cardiac sarcoidosis

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Abstract

Sarcoidosis is a systemic granulomatous disease with a high prevalence of cardiac involvement in autopsic studies. Cardiac sarcoidosis is associated with increased cardiovascular morbidity and mortality. Endomyocardial biopsy is a specific technique, but unfortunately not sensitive enough. Non-invasive cardiac imaging has an important role in the evaluation of patients with suspected or confirmed cardiac sarcoidosis. Echocardiography remains the first choice imaging technique because of its availability and low cost. However, this method could not provide tissue characterization or evaluation of disease activity level. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has essential role in diagnosis and monitoring of patients with suspected or confirmed cardiac sarcoidosis. Nevertheless, more recently it has been shown that cardiac magnetic resonance (CMR) might provide useful information about cardiac sarcoidosis. Hybrid imaging approach that includes PET-CMR and PET-CT is particularly interesting for diagnosis, assessment of activity and follow-up in these patients. Diagnostic algorithm in sarcoidosis patients should include clinical data, hybrid imaging and biopsy. Use of different CMR sequences such as cine imaging, late gadolinium enhancement, T1 and T2 map**, as well as strain imaging, may significantly contribute to diagnosis and monitoring of patients with cardiac sarcoidosis. However, validation of these techniques and particularly T1 and T2 map** in sarcoidosis patients in large studies is necessary. This review aimed to summarize current knowledge about clinical usefulness of CMR in patients with cardiac sarcoidosis.

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Authors and Affiliations

  1. Department of Cardiology, University Hospital “Dr. Dragisa Misovic - Dedinje”, Heroja Milana Tepica 1, Belgrade, 11000, Serbia

    Marijana Tadic

  2. University of Milan-Bicocca, Milan, Italy

    Cesare Cuspidi

  3. Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036, Meda, Italy

    Cesare Cuspidi

  4. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway

    Sahrai Saeed

  5. Clinic of Urology, Clinical Center of Serbia, Belgrade, Serbia

    Bogomir Milojevic

  6. Center for Nuclear Medicine Clinical Center of Serbia, Belgrade, Serbia

    Isidora Grozdic Milojevic

Authors
  1. Marijana Tadic
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  2. Cesare Cuspidi
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  3. Sahrai Saeed
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  4. Bogomir Milojevic
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  5. Isidora Grozdic Milojevic
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Contributions

MT and CC wrote the article, SS reviewed the literature, and BM and IGM reviewed the article with important scientific input.

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Correspondence to Marijana Tadic.

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The paper “The role of cardiac magnetic resonance in diagnosis of cardiac sarcoidosis” has not been submitted elsewhere, it is not under review, or published previously.

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Tadic, M., Cuspidi, C., Saeed, S. et al. The role of cardiac magnetic resonance in diagnosis of cardiac sarcoidosis. Heart Fail Rev 26, 653–660 (2021). https://doi.org/10.1007/s10741-020-10035-z

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