Wang Yangyang, Yang Guangjie, Yan Wenlong, Yu Wenji, Li Ben, Yan Lei, Zhang Ju, Wang Xin, Zhuang Yuan, Wang Zhenguang, Wang Yuetao
Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province.
PET Center, Department of Nuclear Medicine.
Nucl Med Commun. 2025 Sep 1;46(9):824-834. doi: 10.1097/MNM.0000000000002002. Epub 2025 Jun 5.
This study investigated the relationship between cardiac fibroblast activation and clinical parameters, electrophysiological findings, serum fibrosis markers, and hepatic fibroblast activation in patients with chronic liver disease.
In this prospective study conducted from December 2021 to April 2022, 46 patients with chronic liver disease underwent fluorine-18 ( 18 F)-labeled fibroblast activation protein inhibitor (FAPI) PET/computed tomography (CT) imaging and 12-lead electrocardiogram (ECG). Abnormal cardiac 18 F-FAPI uptake was defined as uptake greater than that of the blood pool.
Among 46 patients with chronic liver disease analyzed, 14 showed positive myocardial FAPI uptake and 32 were negative. Significant differences were observed between positive and negative myocardial 18 F-FAPI PET/CT imaging groups in terms of age ( P = 0.006), epicardial fat volume (EFV) ( P = 0.004), Cornell voltage QRS amplitude ( P = 0.022), and QRS duration ( P = 0.032). The multivariable logistic regression analysis demonstrated a significant association between EFV [odds ratio (OR) = 1.019; P = 0.024] and age (OR = 1.162; P = 0.019) and positive myocardial FAPI uptake. Myocardial maximum target-to-background ratio (TBR max ) was positively correlated with hepatic TBR max ( r = 0.405; P = 0.005) and hepatic TBR mean ( r = 0.412, P = 0.004). Moreover, myocardial maximum standardized uptake value was positively correlated with serum laminin levels ( r = 0.367; P = 0.042).
In patients with chronic liver disease, FAPI PET/CT imaging observed cardiac fibroblast activation, which was associated with electrophysiological parameters, hepatic FAPI uptake, and serum liver fibrosis markers. These findings suggest that 18 F-FAPI PET/CT imaging may offer a noninvasive approach for identifying early myocardial changes in chronic liver disease.
本研究调查了慢性肝病患者心脏成纤维细胞活化与临床参数、电生理结果、血清纤维化标志物及肝成纤维细胞活化之间的关系。
在这项于2021年12月至2022年4月进行的前瞻性研究中，46例慢性肝病患者接受了氟-18（¹⁸F）标记的成纤维细胞活化蛋白抑制剂（FAPI）PET/计算机断层扫描（CT）成像及12导联心电图（ECG）检查。心脏¹⁸F-FAPI摄取异常定义为摄取高于血池。
在分析的46例慢性肝病患者中，14例心肌FAPI摄取呈阳性，32例呈阴性。心肌¹⁸F-FAPI PET/CT成像阳性和阴性组在年龄（P = 0.006）、心外膜脂肪体积（EFV）（P = 0.004）、康奈尔电压QRS波幅（P = 0.022）和QRS时限（P = 0.032）方面存在显著差异。多变量逻辑回归分析显示，EFV[比值比（OR）= 1.019；P = 0.024]和年龄（OR = 1.162；P = 0.019）与心肌FAPI摄取阳性之间存在显著关联。心肌最大靶本底比（TBR max）与肝脏TBR max呈正相关（r = 0.405；P = 0.005），与肝脏TBR均值也呈正相关（r = 0.412，P = 0.004）。此外，心肌最大标准化摄取值与血清层粘连蛋白水平呈正相关（r = 0.367；P = 0.042）。
在慢性肝病患者中，FAPI PET/CT成像观察到心脏成纤维细胞活化，这与电生理参数、肝脏FAPI摄取及血清肝纤维化标志物相关。这些发现表明¹⁸F-FAPI PET/CT成像可能为识别慢性肝病早期心肌变化提供一种非侵入性方法。
