Myocardial fibrosis activity in cardiovascular disease

Fibrosis is a fundamental healing response to injury and a central pathological feature of many cardiovascular diseases.

However, it is not currently possible to identify active ongoing cardiac fibrosis with established techniques and this remains a key priority if we are to progress the field.

Preliminary data suggest 68Gallium-fibroblast activation protein inhibitor (68Ga-FAPI) can directly visualise fibrosis activity.

In this Senior Fellowship, I will use 68Ga-FAPI with hybrid magnetic resonance and positron emission tomography (PET/MR) to investigate myocardial fibrosis activity in patients with cardiovascular disease.

I will first use 68Ga-FAPI to differentiate acute from chronic myocardial infarction and to understand the timing of fibrosis activity following infarction.

I will then use 68Ga-FAPI to investigate myocardial fibrosis activity and disease progression in patients with aortic stenosis as well as its reversibility after valve replacement.

Finally, I will use this technique to detect the early stages of chemotherapy-induced cardiotoxicity to help identify patients at risk of future cardiac dysfunction.

If successful, this Senior Fellowship will provide the first prospective and systematic investigation of myocardial fibrosis activity in humans, establishing an exciting new area of cardiovascular science with potential application to a wide range of disorders in the heart, vasculature and beyond.