{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:26:16Z","timestamp":1762899976404,"version":"3.37.3"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Presentation of life-threatening arrhythmias concomitantly with a new-onset non-ischaemic cardiomyopathy raises concern for an inflammatory cardiomyopathy such as cardiac sarcoidosis or cardiac manifestations of connective tissue disease. Comprehensive workup for specific aetiologies may be unrevealing except for signs of myocardial inflammation identified on cardiac positron emission tomography (PET). Here, we present five cases of such subjects and their clinical course.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We collected clinical, imaging, pathological, and follow-up data of five subjects presenting with arrhythmias and unexplained new-onset cardiomyopathy. Mean age was 56.2\u2009\u00b1\u20095.8\u2009years. Three subjects presented with ventricular tachycardia and two with atrial arrhythmias. Echocardiography showed a mean left ventricular ejection fraction of 37\u2009\u00b1\u20099%. Significant coronary artery disease was ruled out in all cases as the cause of the cardiomyopathy. All patients underwent cardiac magnetic resonance imaging (MRI) and PET scan at presentation and follow-up. In all patients, cardiac MRI revealed hyperenhancement in epicardial and mid-myocardial pattern in a non-coronary distribution, while PET scan revealed fluorodeoxyglucose (FDG) mismatch defects in multiple foci in a non-coronary distribution. Right ventricular biopsy was obtained in all patients and revealed interstitial fibrosis and cardiomyocyte hypertrophy. On median follow-up of 210\u2009days, all subjects had improvement in both heart failure symptoms and arrhythmias and repeat PET in four out of five patients showed decreased inflammation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>A high level of suspicion for inflammatory cardiomyopathy is needed in patients presenting with new unexplained cardiomyopathy and arrhythmias. A cardiac FDG-PET should be considered for diagnosis if cardiac inflammation is in the differential. This can inform further decisions regarding targeted immunomodulation therapy that may be helpful in this cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa146","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T03:01:00Z","timestamp":1596510060000},"page":"1-9","source":"Crossref","is-referenced-by-count":2,"title":["A case series on inflammatory cardiomyopathy and suspected cardiac sarcoidosis: role of cardiac PET in management"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7347-1298","authenticated-orcid":false,"given":"Peter J","family":"Kennel","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-2034","authenticated-orcid":false,"given":"Farhan","family":"Raza","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53705, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiwon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine, 520 East 70th Street, New York City, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0945-9363","authenticated-orcid":false,"given":"Parmanand","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine, 520 East 70th Street, New York City, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain","family":"Borczuk","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, 520 East 70th Street, New York City, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udhay","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine, 520 East 70th Street, New York City, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8763-6460","authenticated-orcid":false,"given":"Maria","family":"Karas","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine, 520 East 70th Street, New York City, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1328-3447","authenticated-orcid":false,"given":"Irina","family":"Sobol","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine, 520 East 70th Street, New York City, NY 10021, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"2020101507251012200_ytaa146-B1","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1161\/CIRCRESAHA.117.309711","article-title":"Classification, epidemiology, and global burden of cardiomyopathies","volume":"121","author":"McKenna","year":"2017","journal-title":"Circ Res"},{"key":"2020101507251012200_ytaa146-B2","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1161\/CIRCRESAHA.117.310221","article-title":"Inflammatory cardiomyopathic syndromes","volume":"121","author":"Trachtenberg","year":"2017","journal-title":"Circ Res"},{"key":"2020101507251012200_ytaa146-B3","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/j.1365-2796.2011.02396.x","article-title":"Diagnosing isolated cardiac sarcoidosis","volume":"270","author":"Kandolin","year":"2011","journal-title":"J Intern Med"},{"key":"2020101507251012200_ytaa146-B4","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1016\/j.jacc.2016.09.937","article-title":"The quest for new approaches in myocarditis and inflammatory cardiomyopathy","volume":"68","author":"Heymans","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2020101507251012200_ytaa146-B5","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.hrthm.2006.03.031","article-title":"Refractory ventricular tachycardia secondary to cardiac sarcoid: electrophysiologic characteristics, mapping, and ablation","volume":"3","author":"Koplan","year":"2006","journal-title":"Heart Rhythm"},{"key":"2020101507251012200_ytaa146-B6","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1007\/s11886-018-1065-9","article-title":"Echocardiography in sarcoidosis","volume":"20","author":"Kurmann","year":"2018","journal-title":"Curr Cardiol Rep"},{"key":"2020101507251012200_ytaa146-B7","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1111\/echo.13699","article-title":"Differences in right ventricular morphology, not function, indicate the nature of increased afterload in pulmonary hypertensive subjects with normal left ventricular function","volume":"34","author":"Raza","year":"2017","journal-title":"Echocardiography"},{"key":"2020101507251012200_ytaa146-B8","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1007\/s00259-018-4001-8","article-title":"Prognostic role of serial quantitative evaluation of 18F-fluorodeoxyglucose uptake by PET\/CT in patients with cardiac sarcoidosis presenting with ventricular tachycardia","volume":"45","author":"Muser","year":"2018","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2020101507251012200_ytaa146-B9","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1161\/CIRCRESAHA.117.311812","article-title":"Cardiomyopathies: an overview","volume":"121","author":"Braunwald","year":"2017","journal-title":"Circ Res"},{"key":"2020101507251012200_ytaa146-B10","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1161\/CIRCULATIONAHA.105.589663","article-title":"Diagnosis of myocarditis: death of Dallas criteria","volume":"113","author":"Baughman","year":"2006","journal-title":"Circulation"},{"key":"2020101507251012200_ytaa146-B11","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/MCP.0000000000000410","article-title":"Cardiac sarcoidosis: challenges in clinical practice","volume":"23","author":"Bakker","year":"2017","journal-title":"Curr Opin Pulm Med"},{"key":"2020101507251012200_ytaa146-B12","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/S0002-8703(99)70115-8","article-title":"Histologic diagnostic rate of cardiac sarcoidosis: evaluation of endomyocardial biopsies","volume":"138","author":"Uemura","year":"1999","journal-title":"Am Heart J"},{"key":"2020101507251012200_ytaa146-B13","first-page":"50","article-title":"Cardiac sarcoidosis-state of the art review","volume":"7","author":"Hulten","year":"2016","journal-title":"Cardiovasc Diagn Ther"},{"key":"2020101507251012200_ytaa146-B14","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.jacc.2013.09.022","article-title":"Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis","volume":"63","author":"Blankstein","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2020101507251012200_ytaa146-B15","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1378\/chest.11-0263","article-title":"Management of cardiac sarcoidosis in the United States: a Delphi study","volume":"141","author":"Hamzeh","year":"2012","journal-title":"Chest"},{"key":"2020101507251012200_ytaa146-B16","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/j.hlc.2017.02.021","article-title":"The utility of cardiac magnetic resonance imaging in the diagnosis of cardiac sarcoidosis","volume":"26","author":"Stanton","year":"2017","journal-title":"Heart Lung Circ"},{"key":"2020101507251012200_ytaa146-B17","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s11604-018-0727-2","article-title":"Clinical use of cardiac PET\/MRI: current state-of-the-art and potential future applications","volume":"36","author":"Krumm","year":"2018","journal-title":"Jpn J Radiol"},{"key":"2020101507251012200_ytaa146-B18","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.jcmg.2017.02.022","article-title":"Emergence of integrated cardiac magnetic resonance\/positron emission tomography imaging as the preferred imaging modality in cardiac sarcoidosis","volume":"11","author":"Schindler","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"2020101507251012200_ytaa146-B19","doi-asserted-by":"crossref","first-page":"e007408","DOI":"10.1161\/CIRCIMAGING.117.007408","article-title":"Establishing an evidence-based method to diagnose cardiac sarcoidosis: the complementary use of cardiac magnetic resonance imaging and FDG-PET","volume":"11","author":"Miller","year":"2018","journal-title":"Circ Cardiovasc Imaging"},{"key":"2020101507251012200_ytaa146-B20","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1093\/ehjci\/jex340","article-title":"Diagnostic accuracy and prognostic value of simultaneous hybrid 18F-fluorodeoxyglucose positron emission tomography\/magnetic resonance imaging in cardiac sarcoidosis","volume":"19","author":"Wicks","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/4\/1\/33889969\/ytaa146.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/4\/1\/33889969\/ytaa146.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T11:38:28Z","timestamp":1602761908000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/4\/1\/5880210"}},"subtitle":[],"editor":[{"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Carlos Minguito","family":"Carazo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Robert","family":"Sch\u00f5nbauer","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Rahul","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Peysh A","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,8,1]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,8,3]]},"published-print":{"date-parts":[[2020,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa146","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2020,8]]},"published":{"date-parts":[[2020,8,1]]}}}