Nuklearmedizin 2020; 59(02): 133
DOI: 10.1055/s-0040-1708258
Wissenschaftliche Vorträge
Inflammation
© Georg Thieme Verlag KG Stuttgart · New York

Molecular Imaging of Chemokine Receptor CXCR4 Early After Myocardial Infarction Predicts Left Ventricular Remodeling

J Diekmann
1   Medizinische Hochschule Hannover, Klinik für Nuklearmedizin, Hannover
,
T König
2   Medizinische Hochschule Hannover, Klinik für Kardiologie und Angiologie, Hannover
,
JT Thackeray
1   Medizinische Hochschule Hannover, Klinik für Nuklearmedizin, Hannover
,
R Werner
1   Medizinische Hochschule Hannover, Klinik für Nuklearmedizin, Hannover
,
D Weiberg
1   Medizinische Hochschule Hannover, Klinik für Nuklearmedizin, Hannover
,
T Derlin
1   Medizinische Hochschule Hannover, Klinik für Nuklearmedizin, Hannover
,
A Haghikia
3   Charité Universitätsmedizin Berlin, Klinik für Kardiologie, Berlin
,
LC Napp
2   Medizinische Hochschule Hannover, Klinik für Kardiologie und Angiologie, Hannover
,
C Zwadlo
2   Medizinische Hochschule Hannover, Klinik für Kardiologie und Angiologie, Hannover
,
A Schäfer
2   Medizinische Hochschule Hannover, Klinik für Kardiologie und Angiologie, Hannover
,
S Nekolla
4    Technische Universität München, Medizinische Physik, München
,
J Bauersachs
2   Medizinische Hochschule Hannover, Klinik für Kardiologie und Angiologie, Hannover
,
FM Bengel
1   Medizinische Hochschule Hannover, Klinik für Nuklearmedizin, Hannover
› Author Affiliations
Further Information

Publication History

Publication Date:
08 April 2020 (online)

 

Ziel/Aim Acute myocardial infarction (MI) triggers an inflammatory response, which is a determinant of subsequent healing. Here, we speculated that chemokine receptor CXCR4 upregulation early after MI influences left ventricular remodeling and cardiac outcome.

Methodik/Methods 34 patients underwent cardiac MRI, perfusion SPECT and CXCR4 PET/CT with the selective ligand 68 Ga-pentixafor within the first week after MI. Follow up cardiac MRI was conducted after 7.0 ± 1.5 months. Infarct size was determined from difference in SPECT polar maps compared to our reference database. For PET, regional standardized uptake values (SUV) were calculated and polar maps used to define segments with CXCR4 upregulation. MRI yielded left ventricular ejection fraction (LVEF) and area of injury (via late gadolinium enhancement).

Ergebnisse/Results LVEF was improved at follow up (47 ± 10 vs. 52 ± 11 %; p = 0.03) and late enhancement decreased (23 ± 8 vs. 17 ± 6 % of LV; p < 0.001). SUV peak in the infarct territory was significantly higher than blood pool (2.4 ± 0.5 vs. 2.0 ± 0.3; p < 0.001), but had high variance (1.5 to 3.8) among patients. Area of CXCR4 upregulation correlated with initial LVEF (R = −0.52; p = 0.004) and initial extent of late enhancement (R = 0.57; p = 0.001). Notably, area of CXCR4 upregulation also correlated with follow-up LVEF (R = −0.40; p = 0.022) and the change in extent of late enhancement (R = 0.36; p = 0.043). Multivariate analysis identified area of CXCR4 upregulation as prognostic for LVEF, independent of infarct size.

Schlussfolgerungen/Conclusions CXCR4-targeted molecular imaging early after MI bears potential to predict subsequent ventricular remodeling and may be a useful clinical tool for risk stratification and guidance of anti–inflammatory therapies.