Atrial uptake was present in persistent AF and localized mainly in the right atrium, whereas bilateral AAs could be equally involved. Multiple factors contributed to the increased activity in atrium; in particular, the EAT activity was independently correlated with the activity of the atrium and AA.

The goals were to explore the correlation of 18 F-labeled broblast activation protein inhibitor (FAPI) and cardiovascular magnetic resonance (CMR) parameters in ST-elevation myocardial infarction (STEMI) patients with successful primary percutaneous coronary intervention (PPCI) and to investigate the value of FAPI imaging in predicting cardiac functional recovery. MethodsFourteen rst-time STEMI patients (11 men, mean age: 62 ± 11 years) after PPCI were prospectively recruited. All patients underwent baseline FAPI imaging ( 6± 2 days post-MI) and CMR (8 ± 2 days post-MI). Ten patients had convalescent CMR (84 ± 4 days post-MI). Myocardial FAPI activity was analyzed on extent (the percentage of FAPI uptake volume over the left ventricular volume, FAPI%), intensity (target-to-background uptake ratio, TBRmax), and amount (FAPI%×TBRmax). Serum biomarkers during the acute phase, late gadolinium enhancement (LGE), T2-weighted imaging (T2WI), extracellular volume (ECV), microvascular obstruction (MVO), and cardiac function from CMR imaging were analyzed. ResultsLocalized but inhomogeneous FAPI uptake was observed, which was larger than the edematous and infarcted myocardium. The MVO area showed lower FAPI uptake compared with the surrounding myocardium. FAPI activity was associated with myocardial injury biomarkers, T2WI, LGE, and ECV at both per-patient and per-segment levels (all p < 0.05). Among the CMR parameters, T2WI had the greatest correlation coe cient with both FAPI% and FAPI%×TBRmax. Baseline TBRmax was correlated with convalescent left ventricular ejection fraction (LVEF)(r = −0.73, p = 0.02). ConclusionFAPI imaging detects more involved myocardium than CMR in reperfused STEMI, and was associated with myocardial damage and convalescent LVEF.

Aims This prospective study explored relevant factors and clinical significance of atrial 18F-fluorodeoxyglucose (FDG) uptake in patients with atrial fibrillation (AF). Methods and results One hundred AF patients underwent baseline FDG imaging prior to radiofrequency catheter ablation (RFCA). Of those, 30 subjects underwent additional FDG imaging at 3 months post-RFCA. Voltage mapping of the left atrium was analysed as a voltage score. Patients who received RFCA were followed for 26 months (17–31 months) to assess recurrence. At baseline FDG imaging, 74% of patients with persistent AF (PsAF) and 24% of patients with paroxysmal AF showed increased atrial FDG uptake. The prevalence was higher in the right atrium (49%) than in the left atrium (15%, P &lt; 0.001) or left atrial appendage (21%, P &lt; 0.001). Multivariate analysis demonstrated that PsAF and elevated B-type natriuretic peptide (BNP) were related to enhanced right atrial (RA) activity, and increased epicardial adipose tissue (EAT) activity was predictive of left atrial (LA) activity. LA activity was inversely associated with voltage score, while increased FDG uptake in the right atrium was predictive of successful AF termination by RFCA. Atrial FDG activities decreased significantly post-RFCA, but none of the FDG parameters were predictive of AF recurrence. Conclusions Enhanced RA activity was associated with elevated BNP level, whereas LA activity was related to the increased activity of EAT and inversely correlated with LA fibrosis. Increased RA activity was predictive of successful AF termination by RFCA in PsAF patients.

Background: Peripheral biomarkers may be affected by various factors, their reliability in reflecting local cardiac inflammatory status in patients with atrial fibrillation (AF) needs further exploration. This prospective study was aimed to investigate the relationship between circulating biomarkers and local cardiac inflammation measured by epicardial adipose tissue (EAT) activity via18F-fluorodeoxyglucose (FDG) imaging in AF patients.Methods: From 2017 to 2018, 83 AF patients [43 persistent AF (PsAF) and 40 paroxysmal AF (PAF)] referred for radiofrequency catheter ablation (RFCA) were recruited. Pre- and post-RFCA blood samples were collected to measure IL-6, IL-8, IL-10, IL-18, TNF-α, Hsp27, Hsp60, Hsp70, PDGF-BB, MMP-2, MMP-9, MPO, TGF-β1, Gal-3, and sST2. Pre-RFCA FDG images were obtained to assess EAT activity. Sixty-seven patients (35 PAF and 32 PsAF) received RFCA were regularly followed for 27 (24, 29) months.Results: Higher hsCRP and IL-6 and lower TGF-β1 were demonstrated in PsAF patients compared with PAF patients. Multivariate logistic regression analysis demonstrated that Gal-3 (OR: 1.221, 95% CI: 1.024–1.456, P = 0.026) and MPO (OR: 1.002, 95% CI: 1.001–1.003, P = 0.027) were independently correlated with EAT activity. The percentage decrease of Hsp60 linearly correlated with that of EAT activity post-RFCA (Spearman rs = 0.455, P = 0.019). Seventeen patients (10 PsAF and 7 PAF) had AF recurrence, but none of the selected biomarkers were predictive of post-RFCA recurrence.Conclusion: Our findings demonstrated that in patients with AF, Gal-3 correlated with local cardiac inflammation, and Hsp60 was associated with the alleviation of cardiac inflammation after RFCA.

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