Cui Yan, Wang Yuxiang, Wang Shu, Du Bulin, Li Xuena, Li Yaming
Department of Nuclear Medicine, The First Hospital of China Medical University, Shenyang 110001, China.
J Clin Med. 2023 Sep 18;12(18):6033. doi: 10.3390/jcm12186033.
Fibrosis is a common healing process that occurs during stress and injury in cardiovascular diseases. The evolution of fibrosis is associated with cardiovascular disease states and causes adverse effects. Fibroblast activation is responsible for the formation and progression of fibrosis. The incipient detection of activated fibroblasts is important for patient management and prognosis. Fibroblast activation protein (FAP), a membrane-bound serine protease, is almost specifically expressed in activated fibroblasts. The development of targeted FAP-inhibitor (FAPI) positron emission tomography (PET) imaging enabled the visualisation of FAP, that is, incipient fibrosis. Recently, research on FAPI PET imaging in cardiovascular diseases increased and is highly sought. Hence, we comprehensively reviewed the application of FAPI PET imaging in cardiovascular diseases based on the state-of-the-art published research. These studies provided some insights into the value of FAPI PET imaging in the early detection of cardiovascular fibrosis, risk stratification, response evaluation, and prediction of the evolution of left ventricular function. Future studies should be conducted with larger populations and multicentre patterns, especially for response evaluation and outcome prediction.
纤维化是心血管疾病应激和损伤过程中常见的愈合过程。纤维化的演变与心血管疾病状态相关，并会产生不良影响。成纤维细胞活化是纤维化形成和进展的原因。早期检测活化的成纤维细胞对患者管理和预后很重要。成纤维细胞活化蛋白（FAP）是一种膜结合丝氨酸蛋白酶，几乎特异性表达于活化的成纤维细胞中。靶向FAP抑制剂（FAPI）正电子发射断层扫描（PET）成像技术的发展使得FAP可视化，即早期纤维化可视化成为可能。近年来，FAPI PET成像在心血管疾病中的研究增多且备受关注。因此，我们基于最新发表的研究对FAPI PET成像在心血管疾病中的应用进行了全面综述。这些研究为FAPI PET成像在心血管纤维化早期检测、风险分层、疗效评估以及左心室功能演变预测方面的价值提供了一些见解。未来的研究应以更大规模人群和多中心模式开展，尤其是在疗效评估和结局预测方面。
