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Background <p>The aim of this study was to evaluate fibroblast activation protein (FAP)-targeted positron emission tomography and computed tomography (PET/CT) imaging as surrogate marker for cardiac fibrosis and therefore as prognostic tool for patients with left-sided valvular heart disease undergoing open-heart surgery.</p> Results <p>In 13 patients (6 men, 7 women; mean age ± SD, 62 ± 13 years) scheduled for aortic and/or mitral valve surgery (aortic, <i>n</i> = 3; mitral, <i>n</i> = 9; both, <i>n</i> = 1) preoperative FAPi-PET/CT ([<sup>68</sup>Ga]Ga-RTX1363S) was perfomred. FAP-positive volume and FAP uptake was quantified by different methods (isocontour with fixed and variable threshold) and correlated to preoperative clinical parameters, including (left ventricular ejection fraction (LVEF) and serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP), as well as to changes in LVEF from preoperatively to 3–6 months follow-up (available for <i>n</i> = 11 patients). FAP-uptake in the left ventricular (LV) myocardium was highly variable in the study cohort. Isocontour-55%-based FAP-positive volume was found to correlate statistically significantly with preoperative LVEF (<i>p</i> = 0.03) and preoperative NT-proBNP (<i>p</i> = 0.02). In addition, we found a significant correlation with the change in LVEF from preoperatively to 3–6 months follow-up examination (<i>p</i> = 0.04).</p> Conclusions <p>Preoperative FAPi PET/CT seems to have potential to predict LVEF changes after valvular heart surgery and may therefore be an important tool for risk stratification of asymptomatic patients with left-sided valvular heart disease to support the appropriate timing of valvular surgery.</p>

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FAPi-PET/CT as surrogate marker for subclinical myocardial fibrosis is a prognostic tool for patients undergoing left-sided heart valve surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月3日

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  • Theresa Holst,
  • Alexander Dierks,
  • Marianne Patt,
  • Georgine Wienand,
  • Lisa Müller,
  • Christian H. Pfob,
  • Malte Kircher,
  • Sina Stock,
  • Constantin Lapa,
  • Evaldas Girdauskas,
  • Ralph A. Bundschuh

摘要

Background

The aim of this study was to evaluate fibroblast activation protein (FAP)-targeted positron emission tomography and computed tomography (PET/CT) imaging as surrogate marker for cardiac fibrosis and therefore as prognostic tool for patients with left-sided valvular heart disease undergoing open-heart surgery.

Results

In 13 patients (6 men, 7 women; mean age ± SD, 62 ± 13 years) scheduled for aortic and/or mitral valve surgery (aortic, n = 3; mitral, n = 9; both, n = 1) preoperative FAPi-PET/CT ([68Ga]Ga-RTX1363S) was perfomred. FAP-positive volume and FAP uptake was quantified by different methods (isocontour with fixed and variable threshold) and correlated to preoperative clinical parameters, including (left ventricular ejection fraction (LVEF) and serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP), as well as to changes in LVEF from preoperatively to 3–6 months follow-up (available for n = 11 patients). FAP-uptake in the left ventricular (LV) myocardium was highly variable in the study cohort. Isocontour-55%-based FAP-positive volume was found to correlate statistically significantly with preoperative LVEF (p = 0.03) and preoperative NT-proBNP (p = 0.02). In addition, we found a significant correlation with the change in LVEF from preoperatively to 3–6 months follow-up examination (p = 0.04).

Conclusions

Preoperative FAPi PET/CT seems to have potential to predict LVEF changes after valvular heart surgery and may therefore be an important tool for risk stratification of asymptomatic patients with left-sided valvular heart disease to support the appropriate timing of valvular surgery.