Myocardial Remodeling After AMI
Conditions
Brief summary
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.
Interventions
PET and MRI in patients with acute myocardiac infarction are simultaneously analyzed using hybrid PET/MRI device for monitoring myocardial fibrosis and function.
Sponsors
Study design
Eligibility
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Target-to-background Ratio (TBR) | One week after acute myocardial infarction | 68Ga-FAPI uptake ratio of highly active fibrotic myocardium to heart blood pool on PET images |
| Metabolic volume (MV) | One week after acute myocardial infarction | Volume of highly active fibrotic myocardium on PET images |
| Infarction size (IS) | One week after acute myocardial infarction | Percentage of late gadolinum enhancement area in the entire myocardium on MRI |
| Ejection fraction (EF) | One week after acute myocardial infarction | Left ventricular ejection function evaluated on MRI |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| NT-pro-BNP | One week after acute myocardial infarction | Serum marker of chronic heart failure |
| hsCRP | One week after acute myocardial infarction | Serum marker of acute myocardial inflammation |
Countries
China