Assessing the Effect of Repeat PET Imaging on Treatment Response and Cardiovascular Outcomes among a Homogenously Treated Cohort of Patients with Suspected Cardiac Sarcoidosis

• Published in: Journal of nuclear cardiology 2024-11, p.102082, Article 102082
• Main Authors: Rojulpote, Chaitanya, Bhattaru, Abhijit, Patil, Shivaraj, Adams, Sarah L., Salas, Jonathan A., Vidula, Mahesh K., Perez, Raul Porto, KC, Wumesh, Patterson, Karen, Clancy, Caitlin B., Rossman, Milton, Goldberg, Lee, Bravo, Paco E.
• Format: Article
• Language: English
• ISSN: 1071-3581; 1532-6551; 1532-6551
• DOI: 10.1016/j.nuclcard.2024.102082

Serial PET imaging is routinely employed to monitor treatment response in patients with suspected cardiac sarcoidosis (CS). Corticosteroids remain the mainstay of therapy in CS. However, there are no data available on the cardiovascular outcomes and optimal timing interval to obtain repeat PET while factoring in the influence of corticosteroid taper in relation to surveillance imaging.INTRODUCTIONSerial PET imaging is routinely employed to monitor treatment response in patients with suspected cardiac sarcoidosis (CS). Corticosteroids remain the mainstay of therapy in CS. However, there are no data available on the cardiovascular outcomes and optimal timing interval to obtain repeat PET while factoring in the influence of corticosteroid taper in relation to surveillance imaging.We identified 81 patients with suspected CS (Age: 56.3 ± 1.9, 67% male, LVEF 46.5 ± 3) who were treatment naïve and demonstrated inflammation on baseline PET, subsequently started on moderate-dose prednisone monotherapy (i.e., 30-40 mg/day), and had a diagnostic follow-up PET. Treatment response was graded as complete (CTR) or partial (PTR), and no-response (NTR). Patients were divided into tertiles based on follow-up time between PET scans; tertile-1 (6.8 months; median 9.8 months). Corticosteroid taper was captured by measuring weekly changes in prednisone from start of treatment to up to one-year follow-up. Major adverse cardiovascular events (MACE), defined as sustained ventricular arrhythmias were documented during the first year post-baseline PET.METHODSWe identified 81 patients with suspected CS (Age: 56.3 ± 1.9, 67% male, LVEF 46.5 ± 3) who were treatment naïve and demonstrated inflammation on baseline PET, subsequently started on moderate-dose prednisone monotherapy (i.e., 30-40 mg/day), and had a diagnostic follow-up PET. Treatment response was graded as complete (CTR) or partial (PTR), and no-response (NTR). Patients were divided into tertiles based on follow-up time between PET scans; tertile-1 (6.8 months; median 9.8 months). Corticosteroid taper was captured by measuring weekly changes in prednisone from start of treatment to up to one-year follow-up. Major adverse cardiovascular events (MACE), defined as sustained ventricular arrhythmias were documented during the first year p