Cardiac Fibroblast Activation Detected by 68Ga-FAPI PET/MR

Study Overview
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Brief Summary
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Myocardial infarction is the most common cause of high mortality in the modern world. The short-term survival rate of ST-elevated myocardial infarction (STEMI) has been dramatically increased in the past decades thanks to primary coronary intervention and standardization of treatment. However, the long-term prognosis of patients with acute myocardial infarction (AMI) is still poor, especially in the aging population, due to heart failure related to inappropriate myocardial fibrosis and subsequent left ventricular (LV) remodeling. Despite the amelioration of STEMI management, LV remodeling still occurs in approximately 1/3 of all STEMI patients. Therefore, early identification of such patients may help the optimization of therapy and eventually the outcomes. One characteristic of activated cardiac fibroblasts is the expression of FAP (fibroblast activation protein). A tracer (FAP inhibitor) for positron emission tomography that targets FAP has been used to measure relative FAP density indicative of activated fibroblasts in different cancer entities. However, whether it can reliably assess myocardial fibrosis and predict the poor prognosis caused by LV remodeling is not yet known. Therefore, We aim to observe active myocardial fibrosis process in patients with AMI, and analyze its relationship with the patients'prognosis in a longitudinal study through 68Ga-FAPI PET/MRI.

Official Title
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Cardiac Fibroblast Activation Detected by 68Ga-FAPI PET/MR is a Prognostic Indicator in Patients With Myocardial Infarction.

Conditions
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Myocardial Remodeling After AMI

Intervention / Treatment
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* Diagnostic Test: 68Ga-FAPI PET/MRI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: between 18-75 years old diagnosed with coronary angiography performed percutaneous coronary intervention，with successful myocardial reperfusion Exclusion Criteria: unstable hemodynamics MR contraindications (such as pacemaker or nerve stimulator or metal foreign body, high fever, severe renal failure, etc.) Claustrophobia

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acute myocardial infarction patient group<br> | Diagnostic Test: 68Ga-FAPI PET/MRI<br>* PET and MRI in patients with acute myocardiac infarction are simultaneously analyzed using hybrid PET/MRI device for monitoring myocardial fibrosis and function.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Target-to-background Ratio (TBR) | 68Ga-FAPI uptake ratio of highly active fibrotic myocardium to heart blood pool on PET images | One week after acute myocardial infarction | 
| Metabolic volume (MV) | Volume of highly active fibrotic myocardium on PET images | One week after acute myocardial infarction | 
| Infarction size (IS) | Percentage of late gadolinum enhancement area in the entire myocardium on MRI | One week after acute myocardial infarction | 
| Ejection fraction (EF) | Left ventricular ejection function evaluated on MRI | One week after acute myocardial infarction | 
| Target-to-background Ratio (TBR) | 68Ga-FAPI uptake ratio of highly active fibrotic myocardium to heart blood pool on PET images | Six months after acute myocardial infarction | 
| Metabolic volume (MV) | Volume of highly active fibrotic myocardium on PET images | Six months after acute myocardial infarction | 
| Infarction size (IS) | Percentage of late gadolinum enhancement area in the entire myocardium on MRI | Six months after acute myocardial infarction | 
| Ejection fraction (EF) | Left ventricular ejection function evaluated on MRI | Six months after acute myocardial infarction | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NT-pro-BNP | Serum marker of chronic heart failure | One week after acute myocardial infarction | 
| hsCRP | Serum marker of acute myocardial inflammation | One week after acute myocardial infarction | 
| NT-pro-BNP | Serum marker of chronic heart failure | Six months after acute myocardial infarction | 
| hsCRP | Serum marker of acute myocardial inflammation | Six months after acute myocardial infarction |