Heart scarring, also known as fibrosis, plays a major role in a lot of heart muscle abnormalities. These abnormalities of the heart muscle can lead to major issues such as symptoms of heart failure, dangerous heart rhythm disturbances and even death. However, a lot of these conditions are still not fully understood and treatment options are limited. We here aim to use a new radioactive dye called 68Ga-FAPI to identify patterns and the activity of heart muscle scarring. This radioactive dye is being used in humans particularly in identifying and monitoring cancers and has shown promise in identifying scarring in the heart as well. This will help us not only understand the underlying disease process and risk stratify these patients but also potentially help us develop new targeted therapies that can affect heart muscle scarring. Participants will undergo a baseline MRI scan using this new dye and a plain MRI scan will repeated 12-18 months after to see if there are any changes in the process.
Male or female between 30 to 90 years old
Provision of informed consent prior to any study specific procedures
Patients with symptomatic heart failure with preserved ejection fraction as defined by the presence of heart failure symptoms (dyspnoea, reduced exercise tolerance, fatigue), signs (elevated jugular venous pressure, pulmonary crackles, peripheral oedema) as well as echocardiographic features (preserved left ventricular systolic function (>50%) and reduced diastolic function with septal e' <7cm/s or lateral e' <10cm/s).
Male or female between 30 to 90 years old
Inability or unwilling to give informed consent.
History of claustrophobia or inability to tolerate supine position for the PET/MR or PET/CT scans.
Impaired renal function with eGFR of <30 mL/min/1.73 m2.
Women who are pregnant or breastfeeding.
As highlighted in the inclusion criteria above
Cohort
Prospective
68Ga-FAPI or 18F-AlF-FAPI cardiac PET-MR
Diagnostic test200MBq of the above named radiotracer will be administered for PET-MR
Echocardiogram
Diagnostic testEchocardiogram at baseline and 1 year follow-up
Cardiac MRI
Diagnostic testCardiac MRI at 1 year
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Treatment groupsSee each treatment group below.
Standardised uptake values
Target-to-background ratio
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