{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:12:58Z","timestamp":1788516778501,"version":"build-2803163510"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac sarcoidosis remains a major diagnostic challenge when myocardial inflammation occurs in the absence of clinically active extracardiac disease. In this setting, non-invasive tissue characterization and metabolic imaging may provide critical incremental value over conventional structural assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 62-year-old woman with progressive exertional dyspnoea and long-standing ventricular ectopy underwent multimodality evaluation. Echocardiography showed mild biventricular systolic dysfunction, reduced global longitudinal strain, and focal basal-to-mid septal abnormalities. Coronary computed tomography (CT) angiography excluded obstructive coronary artery disease and showed inactive pulmonary granulomatous sequelae. Cardiac magnetic resonance demonstrated mild-to-moderate biventricular dysfunction and patchy non-ischaemic late gadolinium enhancement in the basal-to-mid septum with elevated native T1 values but no T2 evidence of oedema. 18F-fluorodeoxyglucose positron emission tomography\/CT subsequently revealed focal and multifocal myocardial uptake on a suppressed background, confirming active myocardial inflammation without extracardiac hypermetabolic disease. Immunosuppressive therapy was initiated, and guideline-directed heart failure therapy was optimized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates how stepwise multimodality imaging can establish the diagnosis of active cardiac sarcoidosis, provide precise non-invasive tissue characterization, distinguish active inflammation from fibrosis, and directly guide immunosuppressive treatment when extracardiac disease is clinically silent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag545","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:44:24Z","timestamp":1786535064000},"source":"Crossref","is-referenced-by-count":0,"title":["Active clinically isolated cardiac sarcoidosis with inactive pulmonary sequelae: incremental diagnostic value of multimodality imaging: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6331-7978","authenticated-orcid":false,"given":"Leonardo","family":"Brice\u00f1o Loaiza","sequence":"first","affiliation":[{"name":"Department of Cardiac Imaging, Solca Hospital , Av. Salvador Bustamante Celi y Agust\u00edn Carri\u00f3n, Loja 110104 ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1079-3653","authenticated-orcid":false,"given":"Ximena","family":"Celi Loaiza","sequence":"additional","affiliation":[{"name":"Department of Cardiac Imaging, Hospital Moinhos de Vento , R. Ramiro Barcelos 910, Porto Alegre, RS 90570-001 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"2026090405214963100_ytag545-B1","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1253\/circj.CJ-19-0508","article-title":"JCS 2016 Guideline on Diagnosis and Treatment of Cardiac Sarcoidosis\u2015Digest Version","volume":"83","author":"Terasaki","year":"2019","journal-title":"Circ J"},{"key":"2026090405214963100_ytag545-B2","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1093\/eurheartj\/ehad067","article-title":"Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis","volume":"44","author":"Lehtonen","year":"2023","journal-title":"Eur Heart J"},{"key":"2026090405214963100_ytag545-B3","doi-asserted-by":"crossref","first-page":"2697","DOI":"10.1093\/eurheartj\/ehae356","article-title":"Management of cardiac sarcoidosis","volume":"45","author":"Sharma","year":"2024","journal-title":"Eur Heart J"},{"key":"2026090405214963100_ytag545-B4","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.hrthm.2014.03.043","article-title":"HRS Expert Consensus Statement on the Diagnosis and Management of Arrhythmias Associated With Cardiac Sarcoidosis","volume":"11","author":"Birnie","year":"2014","journal-title":"Heart Rhythm"},{"key":"2026090405214963100_ytag545-B5","doi-asserted-by":"crossref","first-page":"e1197","DOI":"10.1161\/CIR.0000000000001240","article-title":"Diagnosis and management of cardiac sarcoidosis: a scientific statement from the American Heart Association","volume":"149","author":"Cheng","year":"2024","journal-title":"Circulation"},{"key":"2026090405214963100_ytag545-B6","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.2967\/jnumed.117.196287","article-title":"Joint SNMMI\u2013ASNC Expert Consensus Document on the Role of 18F-FDG PET\/CT in Cardiac Sarcoid Detection and Therapy Monitoring","volume":"58","author":"Chareonthaitawee","year":"2017","journal-title":"J Nucl Med"},{"key":"2026090405214963100_ytag545-B7","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1111\/echo.13281","article-title":"Improved detection of myocardial damage in sarcoidosis using longitudinal strain in patients with preserved left ventricular ejection fraction","volume":"33","author":"Murtagh","year":"2016","journal-title":"Echocardiography"},{"key":"2026090405214963100_ytag545-B8","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.jcmg.2012.10.021","article-title":"CMR imaging predicts death and other adverse events in suspected cardiac sarcoidosis","volume":"6","author":"Greulich","year":"2013","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026090405214963100_ytag545-B9","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1016\/j.jcmg.2019.06.024","article-title":"Diagnostic specificity of basal inferoseptal triangular late gadolinium enhancement for identification of cardiac sarcoidosis","volume":"12","author":"Kuo","year":"2019","journal-title":"JACC Cardiovasc Imaging"}],"container-title":["European Heart Journal - 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