MYOCARDIAL INVOLVEMENT IN PATIENTS WITH SARCOIDOSIS - AN ANALYSIS OF 75 PATIENTS

The authors studied 75 nonselected patients (30 men and 45 women; mean age 48 years) with sarcoidosis retrospectively to assess the applicab ility of nuclear examinations for detecting myocardial involvement. Al l patients were studied with Tl-201 myocardial perfusion scan (TMPS), Ga-67 myocardial scan (GMS), and left ventricular ejection fraction (L VEF) using ECG-gated radionuclide ventriculography. The positive GMS g roup had a significantly higher occurrence of abnormality on TMPS (100 %) than the negative GMS group (41%). Patients with TMPS abnormality a nd positive GMS showed significantly lower LVEF (36.3%) than those of normal perfusion or negative GMS. When LVEF decreased, occurrences of TMPS abnormality and positive GMS increased. The authors demonstrate t hat in patients with sarcoidosis LVEF was closely related to TMPS and GMS, and LVEF reflected the progression of sarcoid heart disease and c an be considered a reliable indicator of cardiac function. Patients wi th sarcoidosis with TMPS abnormality and positive GMS should be though t to have myocardial sarcoidosis and their cardiac functions can be as sessed by ECG-gated radionuclide ventriculography, while the remaining patients should be examined with TMPS and GMS periodically for detect ion of myocardial involvement.