By using magnetic resonance imaging, or MRI, to discover minute areas of heart damage before they grow larger, physicians may be able to take action to prevent sudden cardiac death, which is a leading cause of death in patients with sarcoidosis, the researchers said.

Sarcoidosis is characterized by the formation of tiny inflammatory growths called granulomas. Although granulomas tend to cluster in the lungs, in lymph nodes and under the skin, they also can form in the heart. When they do, it currently is difficult to determine which patients will develop heart damage, the researchers said.

"We found that MRI was sensitive in detecting small areas of damage in the hearts of patients with sarcoidosis, and we were further able to correlate these areas of damage with future adverse outcomes," said Manesh Patel, M.D., cardiologist at Duke University Medical Center. "The MRI technology is very good at obtaining high-resolution images of heart muscle and distinguishing normally functioning heart cells from those that are damaged or destroyed."

For their analysis, the Duke researchers identified 81 sarcoidosis patients consecutively referred for evaluation at Duke. All of the patients received a standard clinical evaluation including an electrocardiogram and on average 1.6 non-cardiac MRI imaging tests, and a cardiac MRI scan. The conventional method identified 10 patients (12.3 percent) with heart damage, while the cardiac MRI identified 21 patients (26 percent) with areas of heart damage, Patel said.

The imaging technique that the team used is called delayed enhancement cardiac MRI. In this approach, the researchers inject trace amounts of the element gandolinium into patients before administering the MRI scan.; Source: Duke University Medical Center