The evaluation of advanced cardiac imaging biomarkers for diagnosis of cardiac inflammation in patients with sarcoidosis (Dr Katharine Thomas)

Sarcoidosis is a multi-system granulomatous disease.

Cardiac involvement is underdiagnosed, detected clinically in only 5%, but with autopsy studies suggesting a true prevalence of 25-30%.

As cardiac sarcoidosis can present with ventricular arrhythmias, cardiac failure and sudden death, accurate early diagnosis is essential.

There are significant limitations in the current pathway for detection of cardiac sarcoidosis, and is an area of clear unmet clinical need. Diagnosis is usually made via defined criteria, including advanced cardiac imaging such as CMR and PET.

CTCA and novel biomarkers, like the fat attenuation index (FAI), can also detect coronary inflammation and response to treatment.

We will assess the diagnostic performance of advanced comprehensive CMR, PET and CTCA in detecting myocardial and coronary inflammation in patients with systemic sarcoidosis and following therapeutic response.

These results will establish the diagnostic performance of these advanced imaging modalities, and their ability to track cardiac inflammation and response to therapy.

We will also determine the origins of these imaging signals by correlating them with blood biomarkers and immune phenotyping.

The results will inform a planned multi-centre trial for clinical decision-making in the management of suspected cardiac sarcoidosis and be of use in the future monitoring of novel disease-modifying treatments.