Reston, VA (October 21, 2025)--A new approach to PET
imaging offers a promising way for physicians to promptly identify patients who
are at risk for poor functional recovery after a heart attack, according to new
research published in The Journal of Nuclear Medicine. By visualizing
CXCR4--a cellular protein that plays key role in inflammation--this technique can
enable the timely implementation of treatments to mitigate inflammation and
prevent heart failure progression.
Heart attack, also known as acute myocardial infarction (AMI), is a major cause
of cardiovascular death. According to the Centers for Disease Control and
Prevention, more than 800,000 Americans have a heart attack each year. After a
heart attack, patients may develop progressive heart failure. Reliable tools to
determine which patients will functionally recover and which patients will
experience future heart issues, however, are lacking.
"We know that AMI triggers an inflammatory response in the heart,
which is a determinant of subsequent healing," noted Johanna Diekmann, MD,
senior physician at the Department of Nuclear Medicine, Hannover Medical
School, Germany. "Our study sought to image this inflammatory response to gain
spatial and functional information that could predict outcomes and better
inform treatment strategies."
Researchers speculated that CXCR4 upregulation early after AMI would predict
left ventricular remodeling in the heart as well as cardiac structural
functional outcome. To test this hypothesis, they performed comprehensive
multimodal evaluations with CXCR4-targeted PET/CT, myocardial perfusion imaging
(MPI), and cardiac MRI on 49 patients within the first week after AMI.
Follow-up cardiac MRI was also acquired approximately eight months after AMI in
40 of the patients.
The integrative approach demonstrated that CXCR4 upregulation extends beyond
the infarct core, involves the border zone, and correlates with subsequent left
ventricular dysfunction. These findings offer mechanistic insight into the link
between post-ischemic inflammation and remodeling and underscores the clinical
relevance of inflammatory activity after AMI.
"Conventional imaging modalities, including MPI and cardiac MR, predominantly
quantify the extent of irreversible tissue damage but do not capture the
dynamic inflammatory response that governs healing," noted Diekmann. "By
including CXCR4-targeted PET, we can identify patients who exhibit excessive or
prolonged inflammation which may predispose them to adverse remodeling and
heart failure. Such information could, in the future, support risk
stratification and guide emerging anti-inflammatory or reparative therapies in
a precision medicine framework."
"What's more," she continued, "this approach may ultimately facilitate
image-guided therapeutic strategies, allowing nuclear medicine to play an
active role in monitoring and optimizing interventions that modulate
inflammation, repair, and regeneration after cardiac injury."