title: Cardiac αVβ3integrin expression following acute myocardial infarction in humans.
abstract: Maladaptive repair contributes towards the development of heart failure following myocardial infarction (MI). The αvβ3integrin receptor is a key mediator and determinant of cardiac repair. We aimed to establish whether αvβ3integrin expression determines myocardial recovery following MI.
  
  
  
  18F-Fluciclatide (a novel αvβ3-selective radiotracer) positron emission tomography (PET) and CT imaging and gadolinium-enhanced MRI (CMR) were performed in 21 patients 2 weeks after ST-segment elevation MI (anterior, n=16; lateral, n=4; inferior, n=1). CMR was repeated 9 months after MI. 7 stable patients with chronic total occlusion (CTO) of a major coronary vessel and nine healthy volunteers underwent a single PET/CT and CMR.
  
  
  
  18F-Fluciclatide uptake was increased at sites of acute infarction compared with remote myocardium (tissue-to-background ratio (TBRmean) 1.34±0.22 vs 0.85±0.17; p<0.001) and myocardium of healthy volunteers (TBRmean1.34±0.22 vs 0.70±0.03; p<0.001). There was no18F-fluciclatide uptake at sites of established prior infarction in patients with CTO, with activity similar to the myocardium of healthy volunteers (TBRmean0.71±0.06 vs 0.70±0.03, p=0.83).18F-Fluciclatide uptake occurred at sites of regional wall hypokinesia (wall motion index≥1 vs 0; TBRmean0.93±0.31 vs 0.80±0.26 respectively, p<0.001) and subendocardial infarction. Importantly, although there was no correlation with infarct size (r=0.03, p=0.90) or inflammation (C reactive protein, r=-0.20, p=0.38),18F-fluciclatide uptake was increased in segments displaying functional recovery (TBRmean0.95±0.33 vs 0.81±0.27, p=0.002) and associated with increase in probability of regional recovery.
  
  
  
  18F-Fluciclatide uptake is increased at sites of recent MI acting as a biomarker of cardiac repair and predicting regions of recovery.
  
  
  
  NCT01813045; Post-results.
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: William S A
authors.initials: WS
authors.lastname: Jenkins
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Alex T
authors.identifier: 0000-0001-7681-3778
authors.initials: AT
authors.lastname: Vesey
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Stirrat
authors.affiliation: Clinical Research Imaging Center, University of Edinburgh, Edinburgh, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Connell
authors.affiliation: Clinical Research Imaging Center, University of Edinburgh, Edinburgh, UK.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lucatelli
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Anoushka
authors.initials: A
authors.lastname: Neale
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Catriona
authors.initials: C
authors.lastname: Moles
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Vickers
authors.affiliation: Clinical Research Imaging Center, University of Edinburgh, Edinburgh, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Fletcher
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Tania
authors.initials: T
authors.lastname: Pawade
authors.affiliation: Edinburgh Molecular Imaging Ltd, Edinburgh, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Wilson
authors.affiliation: Division of Cardiovascular Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK.
authors.forename: James H F
authors.identifier: 0000-0003-2243-3117
authors.initials: JH
authors.lastname: Rudd
authors.affiliation: Clinical Research Imaging Center, University of Edinburgh, Edinburgh, UK.
authors.forename: Edwin J R
authors.initials: EJ
authors.lastname: van Beek
authors.affiliation: Clinical Research Imaging Center, University of Edinburgh, Edinburgh, UK.
authors.forename: Saeed
authors.initials: S
authors.lastname: Mirsadraee
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Dweck
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: David E
authors.initials: DE
authors.lastname: Newby
mesh_terms: D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D039302:Integrin alphaVbeta3 / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D010455:Peptides; D011092:Polyethylene Glycols; D000072078:Positron Emission Tomography Computed Tomography; D020127:Recovery of Function; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D013997:Time Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: C530281:AH 111585; D015415:Biomarkers; D003287:Contrast Media; D039302:Integrin alphaVbeta3; D010455:Peptides; D011092:Polyethylene Glycols