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OP3 Cardiac fibrosis in carcinoid syndrome: a pilot study

Heart (British Cardiac Society), 2023-10, Vol.109 (Suppl 4), p.A2-A2 [Peer Reviewed Journal]

2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 1355-6037 ;EISSN: 1468-201X ;DOI: 10.1136/heartjnl-2023-BSCI.3

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  • Title:
    OP3 Cardiac fibrosis in carcinoid syndrome: a pilot study
  • Author: Loganath, Krithika ; Craig, Neil ; Joshi, Shruti ; Barton, Anna ; Witthington, Beth ; Clark, Tim ; Semple, Scott ; Williams, Michelle ; Waight, Clint ; Newby, David ; Henriksen, Peter ; Dweck, Marc
  • Subjects: Cardiovascular disease ; Fibroblasts ; Heart
  • Is Part Of: Heart (British Cardiac Society), 2023-10, Vol.109 (Suppl 4), p.A2-A2
  • Description: IntroductionCarcinoid heart disease is characterised by thickening and dysfunction of the right sided heart valves due to endocardial fibrous tissue deposition, eventually leading to right sided heart failure. 68Gallium-labelled fibroblast activation protein inhibitor (68Ga-FAPI) is a novel radiotracer that binds specifically to activated fibroblasts. We used 68Ga-FAPI to investigate the role of fibroblasts in these patients.Methods10 patients with active carcinoid syndrome were recruited. They underwent echocardiography and 68Ga-FAPI (68Ga-FAPI) hybrid positron emission tomography and magnetic resonance (PET-MR) scan. Areas of visual fibroblast activation were reported as well as mean and maximum standardised uptake values (SUVmean and SUVmax). Maximum tissue-to-background ratios (TBRmax) were calculated, corrected for the background.Results2/10 patients had carcinoid heart disease. The mean age was 69.5 years and 5 (50%) were female. In patients with carcinoid heart disease, significant visual uptake was seen at the tricuspid valve and insertion points with a mean SUVmax of 1.82 and TBRmax of 2.49. Two patients with no known cardiac involvement also demonstrated intense visual tricuspid valve uptake to a lesser degree (SUVmax of 1.94 and TBRmax of 1.70).ConclusionWe present the first series investigating 68Ga-FAPI PET-MR in the characterisation of cardiac involvement of carcinoid syndrome. Our data indicate fibroblast activation around the tricuspid valve in patients with and without known cardiac involvement. Further work is required to explore the diagnostic and prognostic implications of these observations.
  • Publisher: London: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 1355-6037
    EISSN: 1468-201X
    DOI: 10.1136/heartjnl-2023-BSCI.3
  • Source: AUTh Library subscriptions: ProQuest Central
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