Key result
Baseline 68Ga-FAPI-04 uptake volume significantly predicted the change in left ventricular end-systolic volume at 12 months after acute myocardial infarction (B 0.083, p=0.023) and late left ventricular remodeling (AUC 0.833).
Why the study?
The study was conducted to observe longitudinal changes in myocardial fibroblast activation using 68Ga-FAPI-04 PET/MR after STEMI and assess its predictive value for late left ventricular remodeling.
Does baseline 68Ga-FAPI-04 PET/MR uptake volume predict late left ventricular remodeling in patients with STEMI?
Observational (n=42)
Single-blind
No
Does baseline 68Ga-FAPI-04 PET/MR uptake volume predict late left ventricular remodeling in patients with STEMI?
Effect estimate: B 0.083 (95% CI 0.014-0.151)
p-value: p=0.023
Baseline 68Ga-FAPI-04 PET/MR uptake volume in the early stage of STEMI can non-invasively quantify myocardial fibroblast activation and predict late left ventricular remodeling.
Baseline 68Ga-FAPI-04 uptake may aid post-STEMI remodeling risk stratification; hypothesis-generating and requires validation before clinical adoption.
Purpose To observe longitudinal changes of myocardial fibroblasts activation by 68 Ga-labeled fibroblast activation protein inhibitor ( 68 Ga-FAPI-04) PET/MR in patients with ST-segment elevated myocardial infarction (STEMI), and assess its predictive value for late left ventricular remodeling (LVR). Methods Forty-two patients with STEMI were included in the study. 68 Ga-FAPI-04 PET/MR was performed at baseline (5.1 ± 3.0 days) and at 12 months (12.0 ± 1.1 months) after STEMI. The extent of activated myocardial fibroblasts were quantified using 68 Ga-FAPI-04 uptake volume (UV). Infarct size was expressed as late gadolinium enhancement (LGE) volume. LVR was defined as > 10% increase in left ventricular end-systolic volume (LVESV) from baseline to 12 months measured by echocardiography. Results Baseline 68 Ga-FAPI-04 uptake volume (UV) was a significant predictor of the change in LVESV (B = 0.083, p = 0.023) from baseline to 12 months after AMI. The LVR group demonstrated higher 68 Ga-FAPI-04 UV at baseline than the non-LVR group (p = 0.013). The area under the curve (AUC) of 68 Ga-FAPI-04 UV at baseline for predicting the LVR reached 0.833 (p = 0.019), with sensitivity of 100.0% and specificity of 60.0%. Conclusion 68 Ga-FAPI-04 PET/MR is a useful tool to non-invasively quantify myocardial fibroblasts activation, and baseline 68 Ga-FAPI-04 UV in the early stage of STEMI may have predictive value for the late LVR.
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Zhang et al. (2022) conducted an observational in ST-segment elevated myocardial infarction (STEMI) (n=42). Baseline 68Ga-FAPI-04 uptake volume was evaluated on Change in left ventricular end-systolic volume (LVESV) from baseline to 12 months (B 0.083, 95% CI 0.014-0.151, p=0.023). Baseline 68Ga-FAPI-04 uptake volume significantly predicted the change in left ventricular end-systolic volume at 12 months after acute myocardial infarction (B 0.083, p=0.023) and late left ventricular remodeling (AUC 0.833).
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