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Tissue-level evidence of fibroblast activation protein inhibitor imaging in hypertrophic obstructive cardiomyopathy: a case series.
European Heart Journal. Case Reports 2024 May
BACKGROUND: Myocardial fibrosis is a key pathological factor for the occurrence of ventricular arrhythmias in hypertrophic obstructive cardiomyopathy (HOCM).
CASE SUMMARY: This case series reports on two patients diagnosed with HOCM who underwent 18 F-fibroblast activation protein inhibitor (FAPI) positron-emission tomography/computed tomography imaging and Morrow myotomy procedure. The collected myocardial tissue was examined histopathologically. Both patients exhibited intense and heterogeneous 18 F-FAPI uptake in the septum, with significant number of activated fibroblasts.
DISCUSSION: Enhanced 18 F-FAPI uptake was observed before irreversible fibrosis, and the degree of 18 F-FAPI uptake was higher in tissue with greater fibrosis. 18 F-FAPI imaging may provide a promising tool for guiding surgical strategy in HOCM, and further research is needed to fully explore its potential in clinical practice.
CASE SUMMARY: This case series reports on two patients diagnosed with HOCM who underwent 18 F-fibroblast activation protein inhibitor (FAPI) positron-emission tomography/computed tomography imaging and Morrow myotomy procedure. The collected myocardial tissue was examined histopathologically. Both patients exhibited intense and heterogeneous 18 F-FAPI uptake in the septum, with significant number of activated fibroblasts.
DISCUSSION: Enhanced 18 F-FAPI uptake was observed before irreversible fibrosis, and the degree of 18 F-FAPI uptake was higher in tissue with greater fibrosis. 18 F-FAPI imaging may provide a promising tool for guiding surgical strategy in HOCM, and further research is needed to fully explore its potential in clinical practice.
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