FAPI显像预测急性心肌梗死后不良心室重构的价值及机制研究

急性心肌梗死（AMI）后心室重构与预后密切相关。常规心脏影像技术侧重于结构和功能的评价，对AMI后不良心室重构的预测尚存在不足。研究表明，心脏成纤维细胞（CFs）在AMI后心室重构中起关键作用。核素标记的成纤维细胞活化蛋白抑制剂（FAPI）显像可以检测AMI后活化CFs，但FAPI显像能否预测AMI后不良心室重构及其机制尚需进一步研究。基于此，本研究拟在大鼠心肌缺血再灌注模型，通过心脏组织病理检测和多时点FAPI显像，探索CFs在心室重构过程中的动态变化规律；在此基础上，通过FAPI显像和超声心动图，明确FAPI显像预测AMI后不良心室重构的价值及机制；并在给予吡非尼酮（抑制CFs活化）干预的大鼠模型，通过FAPI显像和超声心动图，明确FAPI显像能否监测抗纤维化疗效。通过本研究，旨在为临床提供一种新的评价AMI后心室重构及监测抗纤维化疗效的无创影像学方法。

Ventricular remodeling after acute myocardial infarction (AMI) is closely related to prognosis. Conventional cardiac imaging modalities focus on structural and functional evaluation, and the prediction value of adverse ventricular remodeling after AMI are still insufficient. Studies have shown that cardiac fibroblasts (CFs) play a key role in ventricular remodeling after AMI. Radionuclide labeled fibroblast activation protein inhibitor (FAPI) imaging has the ability to detect activated CFs after AMI, but whether FAPI imaging can predict adverse ventricular remodeling after AMI and the underlying mechanism need to be further studied. Accordingly, this study is aimed to explore the dynamic characteristics of CFs in the process of ventricular remodeling through cardiac histopathological analysis and multi-timepoint FAPI imaging in myocardial ischemia-reperfusion rat models. On the basis of pathological study, serial FAPI imaging and echocardiography were conducted in myocardial ischemia-reperfusion rat models with and without pirfenidone (inhibiting CFs activation) treatment to explore the value and underlying mechanism of FAPI imaging on the prediction of adverse ventricular remodeling after AMI, and to investigate the role of FAPI imaging in monitoring the efficacy of anti-fibrosis therapy. The purpose of this study is to provide a new non-invasive imaging approach for evaluating ventricular remodeling and monitoring the efficacy of anti-fibrosis therapy after AMI.