Overview
Ischemic heart failure (IHF) is the final stage of coronary heart disease. Coronary revascularization is an important treatment method for IHF, but it has high perioperative risks and not all patients can benefit from it. Evaluation of viable myocardium is one of the important decision-making methods for IHF, but recent research results have raised doubts about its value. The clinical community urgently needs more precise and comprehensive non-invasive decision-making methods. Fibroblast activation protein inhibitor (FAPI) imaging can specifically identify activated fibroblasts and achieve non-invasive diagnosis of the early and reversible stage of myocardial injury. Previous studies have shown that FAPI imaging can identify more damaged myocardium in various heart diseases compared to existing imaging techniques, demonstrating good clinical application potential. This study aims to conduct a prospective cohort trial for IHF patients who have undergone revascularization, using 18F-FAPI and viable myocardium (18F-FDG) imaging to analyze the degree of improvement in left ventricular ejection fraction after revascularization and major adverse cardiovascular events, and to explore the independent or additive predictive value of 18F-FAPI imaging, in order to provide a more reliable non-invasive imaging decision-making method for the revascularization strategy of IHF patients.
Eligibility
Inclusion Criteria:
① Age ≥ 18 years; ② Meet the above-mentioned IHF diagnostic criteria; ③ Coronary angiography shows suitability for revascularization (PCI or CABG); ④ NYHA cardiac function classification is II-IV; ⑤ Sign the informed consent form.
Exclusion Criteria:
① Heart failure caused by non-ischemic etiologies (such as dilated cardiomyopathy, valvular heart disease, myocarditis, etc.); ② Acute myocardial infarction occurred within the last 3 months; ③ Expected lifespan \< 1 year; ④ Complicated with other severe systemic diseases; ⑤ Has a history of tumors; ⑥ Has any conditions that are unsuitable for revascularization (such as uncorrectable coagulation dysfunction, active bleeding, etc.)
