Heart disease does not always mean a blockage or a heart attack. Sometimes, inflammation can develop within the heart muscles without showing any clear external signs in the early stages. The problem is that by the time symptoms appear, the heart's functioning may already be compromised. A study conducted by AIIMS has raised new hopes for detecting this hidden issue in time.

In this study, researchers used advanced cardiac MRI to identify even minute changes in the heart muscles. Notably, signs of abnormality were detected even in patients whose other tests showed normal results and where changes were not otherwise apparent. Health experts state that this technique could be useful for understanding the disease and assessing its activity in suspected cases.

Conditions like cardiac sarcoidosis can affect heart muscles, leading to risks such as rapid or irregular heartbeats, shortness of breath, and a subsequent decline in the heart's pumping capacity.

A joint study by the departments of Cardiovascular Radiology and Endovascular Interventions, Cardiology, and Geriatric Medicine at AIIMS, Delhi, offers significant relief to heart patients. Patients suffering from hidden heart muscle inflammation (cardiac sarcoidosis) stand to benefit directly. It will now be easier to detect heart inflammation and early-stage damage using advanced cardiac MRI technology.

Experts say this can help assess the damage caused to the heart by the disease, monitor patients, and understand future risks.

Understanding the impact of the disease on heart muscles will become easier.

This study has been published in the *Indian Journal of Radiology and Imaging*. According to doctors, this technique could prove useful in identifying changes within the heart muscles. Dr. Amrinder Singh Malhi, Assistant Professor in the Department of Cardiovascular Radiology and Endovascular Interventions at AIIMS, explained that incorporating T1 mapping, T2 mapping, and Late Gadolinium Enhancement (LGE) into cardiac MRI allows for a better assessment of the disease's impact on the heart muscles.

T1 mapping is an advanced cardiac magnetic resonance imaging technique used to measure the health of heart muscle (myocardium) tissue and detect subtle changes within it.
T2 mapping is a modern, quantitative MRI technique used to accurately assess water content and molecular dynamics within tissues.

Late Gadolinium Enhancement is a specialized imaging technique used in cardiac MRI. Its primary objective is to detect scarring, fibrosis, or dead tissue within the heart muscles.

68 percent of patients complained of rapid heartbeat

The average age of the patients included in the study was 38 years. 68.4 percent of the patients experienced rapid or irregular heartbeats, while 52.63 percent complained of shortness of breath.

MRI scans revealed signs of LGE in 63.15 percent of the patients. The disease's impact was primarily observed in the mid-wall and the outer layer of the heart muscles.

For T1 mapping, using a cutoff of 1,029 milliseconds, the sensitivity for identifying affected areas was 87.5 percent, and the specificity was 96.9 percent. Meanwhile, among the seven patients who appeared normal on LGE, T1 mapping indicated abnormalities in 38 out of the 112 cardiac segments; at least one affected segment was identified in all these patients. Active cardiac inflammation was confirmed in both patients who underwent PET scans.

**Assessing disease activity via MRI**

In the study, among the ten patients who underwent both MRI and PET-CT scans, MRI detected active disease in five patients, while PET detected it in eight. However, the difference between the results of the two tests was not found to be statistically significant.

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