Myocardial fibroblast activation imaging in prediction of cardiac functional improvement of non-ischemic heart failure

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-07-20 DOI:10.1016/j.ijcha.2025.101752

Yao Su , Xin Liu , Ning Fu , Lina Dou , Qili Zhang , Jinxia Zhao , Qi Yang , Cunzhi Lu , Min-Fu Yang

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引用次数: 0

Abstract

Background

Activated myocardial fibroblasts are key contributors to cardiac fibrosis and drive progression toward heart failure (HF). This study aimed to investigate the characteristics of myocardial fibroblast activation imaging and its predictive value for improved cardiac function in non-ischemic HF.

Methods

This double-center prospective study enrolled 38 patients who underwent ^99mTc-labeled-hydrazinonicotinamide-fibroblast activation protein inhibitor-04 (^99mTc-HFAPi) and cardiac magnetic resonance (CMR) imaging. For comparison, 18 healthy volunteers were recruited to undergo ^99mTc-HFAPi imaging as controls, while another 18 controls were selected from the CMR database. Myocardial ^99mTc-HFAPi activity was quantified by intensity, extent, and amount. CMR-derived T1 values, extracellular volume (ECV), and strain were analyzed. Baseline and follow-up echocardiographic data were used to evaluate improved cardiac function.

Results

All patients exhibited intense but inhomogeneous ^99mTc-HFAPi uptake in the left ventricular (LV) myocardium, and the intensity was higher than that of controls (4.1 ± 1.8 vs. 1.2 ± 0.1, p < 0.001). LV ^99mTc-HFAPi amount negatively correlated with LVEF (r = -0.43, p = 0.008). At the segmental level, abnormal ^99mTc-HFAPi uptake was present in 79.8 % of segments, exceeding the prevalence of increased native T1 values (66.1 %) (p < 0.001). At median follow-up of 3 months, patients without improved cardiac function demonstrated significantly higher intensity (5.0 ± 2.0 vs. 3.5 ± 1.6, p = 0.022).

Conclusion

Patients with non-ischemic HF showed intense but heterogeneous ^99mTc-HFAPi activity. The ^99mTc-HFAPi activity was negatively correlated with baseline cardiac systolic function and associated with poor improvement in cardiac function during follow-up.

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心肌成纤维细胞活化显像预测非缺血性心力衰竭心功能改善

活化的心肌成纤维细胞是心脏纤维化的关键因素，并推动心力衰竭（HF）的发展。本研究旨在探讨心肌成纤维细胞激活成像的特点及其对非缺血性心衰心功能改善的预测价值。方法本双中心前瞻性研究纳入38例患者，采用99mtc标记-肼烟酰胺-成纤维细胞活化蛋白抑制剂-04 （99mTc-HFAPi）和心脏磁共振（CMR）成像。为了进行比较，招募了18名健康志愿者进行99mTc-HFAPi成像作为对照，同时从CMR数据库中选择了另外18名对照。心肌99mTc-HFAPi活性通过强度、程度、量进行量化。分析cmr衍生的T1值、细胞外体积（ECV）和菌株。基线和随访超声心动图数据用于评估心功能的改善。结果所有患者左心室（LV）心肌99mTc-HFAPi摄取强烈但不均匀，强度均高于对照组(4.1±1.8∶1.2±0.1,p <；0.001)。lv99mtc - hfapi用量与LVEF呈负相关（r = -0.43, p = 0.008）。在节段水平，79.8%的节段存在99mTc-HFAPi摄取异常，超过了原生T1值升高的患病率（66.1%）(p <；0.001)。在中位随访3个月时，心功能未改善的患者表现出明显更高的强度（5.0±2.0比3.5±1.6,p = 0.022）。结论非缺血性心衰患者99mTc-HFAPi具有强烈但异质性的活性。99mTc-HFAPi活性与基线心脏收缩功能呈负相关，并与随访期间心功能改善不良相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.