Al^(18)F-NOTA-FAPI显像评价肺动脉高压患者左心室成纤维细胞活化特征及相关因素分析  

Characteristics and associated factors of left ventricular fibroblast activation on Al 18F-NOTA-FAPI imaging in patients with pulmonary hypertension

作　　者：陈碧希 龚娟妮[2] 徐洋 杨敏福[1] Chen Bixi;Gong Juanni;Xu Yang;Yang Minfu(Department of Nuclear Medicine,Beijing Chaoyang Hospital of Capital Medical University,Beijing 100020,China;Department of Respiratory and Critical Care,Beijing Chaoyang Hospital of Capital Medical University,Beijing Institute of Respiratory Medicine,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院核医学科,北京100020 [2]首都医科大学附属北京朝阳医院呼吸与危重症医学科、北京呼吸疾病研究所,北京100020

出　　处：《中华核医学与分子影像杂志》2024年第11期644-649,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金(81871380);北京市医院管理中心扬帆计划(ZYLX202105);北京朝阳医院金种子科研基金(CYJZ202207)。

摘　　要：目的探讨肺动脉高压(PH)患者是否会出现左心室游离壁异常成纤维细胞激活蛋白(FAP)抑制剂(FAPI)摄取并分析其特点及意义。方法回顾性分析2021年2月至2024年1月首都医科大学附属北京朝阳医院临床诊断为PH的51例患者[男24例、女27例,年龄(48±21)岁]及10名同期健康志愿者[男4名、女6名,年龄(59±12)岁]的Al^(18)F-1,4,7-三氮杂环壬烷-1,4,7-三乙酸(NOTA)-FAPI-04 PET/CT显像图。观察左心室游离壁FAPI摄取情况,高于血池判定为有异常摄取;测定左心室游离壁的SUV max、SUV mean、左心室FAP总活性。分析左心室FAPI摄取的相关因素,比较有无左心室FAPI异常摄取患者间临床资料的差异。采用两独立样本t检验、Mann-Whitney U检验比较组间差异,采用Spearman秩相关进行相关性分析。结果有19例PH患者出现左心室游离壁异常FAPI摄取,均呈弥漫性分布。左心室FAP总活性与二尖瓣口舒张晚期峰值血流速度(A)呈正相关(r_(s)=0.696,P=0.001),与二尖瓣口舒张早期峰值血流速度(E)/A、肺血管阻力(PVR)呈负相关(r_(s)值:-0.629、-0.540,P值:0.004、0.017)。在有无左心室异常FAPI摄取患者之间,E/A[0.8(0.6,1.1)和0.9(0.8,1.4);z=-2.33,P=0.020]、左心室收缩末期内径[(25.7±2.6)和(27.8±4.2)mm;t=-2.22,P=0.031]、左心室收缩末期容积[(26.7±7.3)和(32.5±9.9)ml;t=-2.26,P=0.028]差异有统计学意义。结论PH患者左心室游离壁会出现FAPI弥漫性异常摄取,其摄取程度与左心室舒张功能受损有关。Objective To investigate whether patients with pulmonary hypertension(PH)develop abnormal fibroblast activation protein(FAP)inhibitor(FAPI)uptake in the left ventricular free wall and to analyze its characteristics and significance.Methods Al^(18)F-1,4,7-triazacyclononane-1,4,7-triacetic acid(NOTA)-FAPI-04 PET/CT images of 51 patients diagnosed with PH(24 males,27 females;age:(48±21)years)and 10 healthy volunteers(4 males,6 females;age:(59±12)years)from Beijing Chaoyang Hospital of Capital Medical University between February 2021 and January 2024 were retrospectively analyzed.Higher FAPI uptake in the left ventricular free wall than that in blood pool was defined as abnormal and SUV max,SUV mean,and total lesion FAP activity were quantitatively measured.Associated factors with FAPI uptake in the left ventricle were analyzed,and differences of clinical parameters between patients with and without abnormal left ventricular uptake were compared.Independent-sample t test and Mann-Whitney U test were used to compare differences between groups.Spearman rank correlation analysis was used for correlation analysis.Results Abnormal FAPI uptake that was diffusely distributed in the left ventricular free wall was observed in 19 patients with PH.Total lesion FAP activity was positively correlated with peak mitral late-diastolic inflow velocity(A)(r s=0.696,P=0.001)and negatively correlated with peak mitral early-diastolic inflow velocity(E)/A and pulmonary vascular resistance(PVR)(r_(s)values:-0.629,-0.540,P values:0.004,0.017).Significant differences in E/A(0.8(0.6,1.1)vs 0.9(0.8,1.4);z=-2.33,P=0.020),left ventricular end-systolic internal diameter((25.7±2.6)vs(27.8±4.2)mm;t=-2.22,P=0.031),and left ventricular end-systolic volume((26.7±7.3)vs(32.5±9.9)ml;t=-2.26,P=0.028)were found between patients with and without abnormal FAPI uptake in the left ventricle.Conclusion In patients with PH,the left ventricular free wall develops diffuse abnormal uptake of FAPI,the extent of which is related to impaired left ventricular di

关 键 词：高血压 肺性 喹啉类 成纤维细胞 氟放射性同位素 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R544.1[医药卫生—心血管疾病] R817.4[医药卫生—内科学]