MAGNET-CS Version 1
Research type
Research Study
Full title
Improving Assessment of Diagnosis and Prognosis in Cardiac Sarcoidosis
IRAS ID
287964
Contact name
Dudley Pennell
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Research Summary
Sarcoidosis is an inflammatory disease that can involve many organs and mainly affects young adults. Heart disease is the second most common cause of death among these patients. The diagnosis of cardiac sarcoidosis remains challenging given the absence of reliable tests including heart muscle biopsy. Abnormalities detected on medical scans of the heart, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), have been associated with a higher risk of future adverse events in suspected cardiac sarcoidosis patients even when the disease does not cause any symptoms, but this has been shown only in small studies. This research project will combine data from MRI and PET scans of the heart with genetic testing in a very large cohort of patients at the Royal Brompton Hospital with suspected cardiac sarcoidosis in order to:1. Understand whether scar and inflammation in the heart detected by MRI and PET can predict the risk of future adverse events.
2. Assess the accuracy of MRI to detect inflammation in the heart versus PET, which is currently the imaging method of choice to detect inflammation in-vivo.
3. Assess the role of genetic testing in the early diagnosis of cardiac sarcoidosis and in predicting risk of heart rhythm abnormalities and heart failure.
4. Combine data from medical scans (MRI and PET) with genetic testing to build a new strategy to assess the risk associated with this heart condition, which could be used by clinicians to improve patient management.
Lay summary of study results
Improving how cardiac Sarcoidosis is diagnosed and its risks predicted
Cardiac sarcoidosis (CS) is an inflammatory heart condition with unknown causes, challenging diagnosis, and unclear risk assessment. CS can cause life-threatening heart rhythm problems, heart failure, and sudden death. This research aimed to improve the way we diagnose and predict outcomes in CS using advanced imaging techniques and genetic analysis.
MRI scans for risk prediction: We demonstrated that specific patterns and locations of heart scarring, visible through a specialized MRI technique called late gadolinium enhancement (LGE), are strong predictors of dangerous heart rhythm problems. Based on these findings, we developed a new method to classify patients' risks, which performed better than an existing system.
Advanced imaging for diagnosing inflammation: We compared two MRI imaging techniques called T1 and T2 mapping versus FDG-PET, a test that uses small amount of a radioactive sugar that lights up in inflamed areas. We found that MRI methods were not very accurate in detecting inflammation compared to FDG-PET, especially for identifying milder inflammation. This finding suggests that combining these imaging techniques provides a more complete picture of heart inflammation in CS.
Genetic links to CS: Preliminary analysis of genetic data of CS patients revealed a higher occurrence of rare mutations in several heart-related genes compared to the general population. These genetic differences may increase the risk of developing CS. Further analysis is required to confirm our early results.
In summary, the study highlights improved tools for predicting life-threatening heart rhythm abnormalities, for diagnosing heart inflammation, and understanding potential genetic causes in CS. These findings could lead to better diagnosis, risk assessment, and treatment strategies for patients with CS.
REC name
London - Chelsea Research Ethics Committee
REC reference
20/LO/1310
Date of REC Opinion
7 Jan 2021
REC opinion
Further Information Favourable Opinion