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Myocardial Activity at 18F-FAPI PET/CT and Risk for Sudden Cardiac Death in Hypertrophic Cardiomyopathy
Abstract
Background Myocardial fibrosis contributes to adverse cardiovascular events in hypertrophic cardiomyopathy (HCM). Purpose To explore the characteristics of cardiac fibroblast activation protein inhibitor (FAPI) PET/CT imaging and its relationship with the risk of sudden cardiac death (SCD) in HCM. Materials and Methods In this prospective study from July 2021 to January 2022, participants with HCM and healthy control participants underwent cardiac fluorine 18 ( 18 F)-labeled FAPI PET/CT imaging. Myocardial FAPI activity was quantified as intensity (target-to-background uptake ratio), extent (the percent of FAPI-avid myocardium of the left ventricle [LV]), and amount (the percent of FAPI-avid myocardium of LV × target-to-background ratio). Regional wall thickness was analyzed at cardiac MRI. The 5-year SCD risk score was calculated from the 2014 European Society of Cardiology guidelines. Univariable and multivariable linear regression analyses were used to identify factors related to the FAPI amount. The correlation between FAPI amount and 5-year SCD risk was explored. Results Fifty study participants with HCM (mean age, 43 years ± 13 [SD]; 32 men) and 22 healthy control participants (mean age, 45 years ± 17; 14 men) were included. All participants with HCM had intense and inhomogeneous cardiac FAPI activity in the LV myocardium that was higher than that in healthy control participants (median target-to-background ratio, 8.8 vs 2.1, respectively; P P N -terminal probrain natri…
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“Radiotracers based on fibroblast activation protein inhibitor (for example, 18 F-FAPI) measure levels of fibroblast activation in the myocardium, reflecting an active fibrotic process, which has correlated with myocardial function, 166 as well as with sudden cardiac death.167”
From Current management of hypertrophic cardiomyopathy (2025) · cites this paper as [167]
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Current management of hypertrophic cardiomyopathy
Sikand, N., Stendahl, J., Sen, S., Lampert, R., & Day, S. (2025) · BMJ · doi:10.1136/bmj-2023-077274 · Cited by 26
Metadata
- Authors
- Wang, L., Wang, Y., Wang, J., Xiao, M., Xi, X.-Y., Chen, B.-X., Su, Y., Zhang, Y., Xie, B., Dong, Z., Zhao, S., & Yang, M.-F.
- Venue
- Radiology
- Published
- 2023-02-01
- Volume
- 306
- Issue
- 2
- ISSN
- 0033-8419
- 1527-1315
- Cited by
- 73
- References
- 1
- Language
- en
- Funders
- National Key Research and Development Program of China (2021YFF0501400, 2021YFF0501401)
- Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (ZYLX202105)
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- The paper
- Wang, L., Wang, Y., Wang, J., Xiao, M., Xi, X.-Y., Chen, B.-X., Su, Y., Zhang, Y., Xie, B., Dong, Z., Zhao, S., & Yang, M.-F. (2023). Myocardial Activity at 18F-FAPI PET/CT and Risk for Sudden Cardiac Death in Hypertrophic Cardiomyopathy. Radiology. https://doi.org/10.1148/radiol.221052