Dietz Matthieu, Kamani Christel H, Dunet Vincent, Fournier Stephane, Rubimbura Vladimir, Testart Dardel Nathalie, Schaefer Ana, Jreige Mario, Boughdad Sarah, Nicod Lalonde Marie, Schaefer Niklaus, Mewton Nathan, Prior John O, Treglia Giorgio
Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland.
INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France.
Front Med (Lausanne). 2022 May 6;9:887508. doi: 10.3389/fmed.2022.887508. eCollection 2022.
Studies using arginine-glycine-aspartate (RGD)-PET agents in cardiovascular diseases have been recently published. The aim of this systematic review was to perform an updated, evidence-based summary about the role of RGD-based PET agents in patients with cardiovascular diseases to better address future research in this setting. Original articles within the field of interest reporting the role of RGD-based PET agents in patients with cardiovascular diseases were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until October 26, 2021. Literature shows an increasing role of RGD-based PET agents in patients with cardiovascular diseases. Overall, two main topics emerged: the infarcted myocardium and atherosclerosis. The existing studies support that αβ integrin expression in the infarcted myocardium is well evident in RGD PET/CT scans. RGD-based PET radiotracers accumulate at the site of infarction as early as 3 days and seem to be peaking at 1-3 weeks post myocardial infarction before decreasing, but only 1 study assessed serial changes of myocardial RGD-based PET uptake after ischemic events. RGD-based PET uptake in large vessels showed correlation with CT plaque burden, and increased signal was found in patients with prior cardiovascular events. In human atherosclerotic carotid plaques, increased PET signal was observed in stenotic compared with non-stenotic areas based on MR or CT angiography data. Histopathological analysis found a co-localization between tracer accumulation and areas of αβ expression. Promising applications using RGD-based PET agents are emerging, such as prediction of remodeling processes in the infarcted myocardium or detection of active atherosclerosis, with potentially significant clinical impact.
近期发表了一些使用精氨酸 - 甘氨酸 - 天冬氨酸（RGD）-PET 显像剂研究心血管疾病的文章。本系统评价的目的是对基于 RGD 的 PET 显像剂在心血管疾病患者中的作用进行更新的、基于证据的总结，以便更好地指导该领域未来的研究。在感兴趣领域内报道基于 RGD 的 PET 显像剂在心血管疾病患者中作用的原始文章符合纳入本系统评价的标准。对 PubMed/MEDLINE 和考克兰图书馆数据库进行了系统的文献检索，检索截至 2021 年 10 月 26 日。文献表明基于 RGD 的 PET 显像剂在心血管疾病患者中的作用日益凸显。总体而言，出现了两个主要主题：梗死心肌和动脉粥样硬化。现有研究支持在 RGD PET/CT 扫描中梗死心肌中αβ整合素表达明显。基于 RGD 的 PET 放射性示踪剂早在心肌梗死后 3 天就在梗死部位聚集，在心肌梗死后 1 - 3 周似乎达到峰值，随后下降，但仅有 1 项研究评估了缺血事件后心肌基于 RGD 的 PET 摄取的系列变化。大血管中基于 RGD 的 PET 摄取与 CT 斑块负荷相关，在既往有心血管事件的患者中发现信号增强。在人类动脉粥样硬化颈动脉斑块中，根据 MR 或 CT 血管造影数据，与非狭窄区域相比，狭窄区域观察到 PET 信号增强。组织病理学分析发现示踪剂聚集与αβ表达区域共定位。基于 RGD 的 PET 显像剂的一些有前景的应用正在出现，如预测梗死心肌的重构过程或检测活动性动脉粥样硬化，可能具有重大临床意义。
