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Research ArticleBasic Science Investigation

Myocardial Fibrosis: Emerging Target for Cardiac Molecular Imaging and Opportunity for Image-Guided Therapy

Frank M. Bengel, Johanna Diekmann, Annika Hess and Michael Jerosch-Herold
Journal of Nuclear Medicine November 2023, 64 (Supplement 2) 49S-58S; DOI: https://doi.org/10.2967/jnumed.122.264867
Frank M. Bengel
1Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany; and
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Johanna Diekmann
1Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany; and
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Annika Hess
1Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany; and
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Michael Jerosch-Herold
2Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
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Abstract

Myocardial fibrosis is a major contributor to the development and progression of heart failure. Significant progress in the understanding of its pathobiology has led to the introduction and preclinical testing of multiple highly specific antifibrotic therapies. Because the mechanisms of fibrosis are highly dynamic, and because the involved cell populations are heterogeneous and plastic, there is increasing emphasis that any therapy directed specifically against myocardial fibrosis will require personalization and guidance by equally specific diagnostic testing for successful clinical translation. Noninvasive imaging techniques have undergone significant progress and provide increasingly specific information about the quantity, quality, and activity of myocardial fibrosis. Cardiac MRI can precisely map the extracellular space of the myocardium, whereas nuclear imaging characterizes activated fibroblasts and immune cells as the cellular components contributing to fibrosis. Existing techniques may be used in complementarity to provide the imaging biomarkers needed for the success of novel targeted therapies. This review provides a road map on how progress in basic fibrosis research, antifibrotic drug development, and high-end noninvasive imaging may come together to facilitate the success of fibrosis-directed cardiovascular medicine.

  • myocardial fibrosis
  • heart failure
  • multimodality imaging
  • molecular imaging
  • fibroblast activation protein

Footnotes

  • Published online Nov. 1, 2023.

  • © 2023 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 64 (Supplement 2)
Journal of Nuclear Medicine
Vol. 64, Issue Supplement 2
November 1, 2023
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Myocardial Fibrosis: Emerging Target for Cardiac Molecular Imaging and Opportunity for Image-Guided Therapy
Frank M. Bengel, Johanna Diekmann, Annika Hess, Michael Jerosch-Herold
Journal of Nuclear Medicine Nov 2023, 64 (Supplement 2) 49S-58S; DOI: 10.2967/jnumed.122.264867

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Myocardial Fibrosis: Emerging Target for Cardiac Molecular Imaging and Opportunity for Image-Guided Therapy
Frank M. Bengel, Johanna Diekmann, Annika Hess, Michael Jerosch-Herold
Journal of Nuclear Medicine Nov 2023, 64 (Supplement 2) 49S-58S; DOI: 10.2967/jnumed.122.264867
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  • Article
    • Abstract
    • MYOCARDIAL FIBROSIS: PATHOPHYSIOLOGIC CONSIDERATIONS
    • EMERGING ROLE OF MYOCARDIAL FIBROSIS AS A THERAPEUTIC TARGET
    • NONINVASIVE IMAGING BIOMARKERS OF MYOCARDIAL FIBROSIS
    • FUTURE PERSPECTIVE: TOWARD FIBROSIS-TARGETED THERANOSTICS
    • DISCLOSURE
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Keywords

  • myocardial fibrosis
  • heart failure
  • multimodality imaging
  • molecular imaging
  • fibroblast activation protein
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