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Serum Angiotensin Converting Enzyme and Coincident Tc-99m-PYP Radionuclide Myocardial Imaging Indicating Presence of Sarcoid Heart Disease in Patients With Pulmonary and/or Systemic Sarcoidosis FREE TO VIEW

Ioannis Angomachalelis, MD; Hercules Titopoulos, MD; Nestor Angomachalelis, MD
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Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece

Chest. 2014;146(4_MeetingAbstracts):365A. doi:10.1378/chest.1994237
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SESSION TITLE: Interstitial Lung Disease Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: : The study aims to evaluate serum angiotensin converting enzyme levels (SACE) and coincident correlation with Technetium radionuclide myocardial imaging(Tc-99m-Pyp) in patients(pts) presented with pulmonary and/or systemic sarcoidosis.

METHODS: Serum SACE levels were measured by Hurst’s and Lorel-Smith’s method in 52 biopsy-proven,Sarcoidosis Pts,15 males and 37 females(mean age 48±12years),without clinical evidence of any other cardiovascular pathology as well as 15 normal individuals (mean age 47±23 years).All patients submitted to clinical evaluation,ECG,Chest X-Ray and Computed Tomography(CT),Echocardiography,Pulmonary Function Tests (PFTs),Arterial Blood Gasses (ABGs) and Tc-99m-Pyp myocardial scintigraphy.Two hours after i.v. injection of 20mCi, the isotope uptake was recorded in various views and evaluated by percent bias methodology between left precardial and right parasternal area,quite independent from the isotope dose infusion, body weight or surface area and renal dysfunction.

RESULTS: The results showed:1) SACE values in normals 32±6 U/min/L. 2) SACE values in sarcoid pts 67±34 U/min/L. 3) 40/52 pts (74%) had statistically increased SACE values. 4) ECG abnormalities were revealed in less than 5% of pts. 5 ) Abnormal isotope uptake in the left parasternal area was confirmed in 38/52 pts (70%). 6) Increased SACE levels coincident with abnormal Tc-99-Pyp uptake was designated in 30 pts (55%).

CONCLUSIONS: We conclude that: 1)There was statistical significant difference of SACE levels between normals and sarcoidosis pts(r=-4.33, 0,01>p>0,001). 2) Abnormal radionuclide myocardial imaging could be strongly suggestive of infiltrative myocardial involvement. 3) The coincidence of increased SACE values and abnormal Tc-99m-Pyp scintigraphy in 55% of pts could be compatible with sarcoid heart disease.

CLINICAL IMPLICATIONS: Further extended investigation studies should be carried out to confirm confidence of investigation data and establish reliability of the coincident evaluation of SACE measurements with radionuclide Tc-99m-Pyp myocardial scintigraphy.

DISCLOSURE: The following authors have nothing to disclose: Ioannis Angomachalelis, Hercules Titopoulos, Nestor Angomachalelis

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