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Updated: Jun 12, 2026
06:08
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Primary Aldosteronism: CXCR4- and FAP-Targeted PET/MR for Adrenal-Cardiac Axis
Jie Ding1,2, Kun Wang1, Jun Song3
1Department of Nuclear Medicine (J.D., K.W., X. Cheng, F.Y., X. Chen, Z.Y., Z.Z., N.Q., H.W., J.Z.), Shanghai East Hospital, Tongji University School of Medicine, China.
Circulation. Cardiovascular Imaging
|June 11, 2026
Summary
Primary aldosteronism (PA) involves cardiac risk beyond blood pressure. Imaging reveals a link between adrenal activity and heart remodeling, with potential for improvement after treatment.
Area of Science:
- Cardiovascular Imaging
- Endocrinology
- Molecular Imaging
Background:
- Primary aldosteronism (PA) is linked to cardiovascular risks not solely explained by hypertension.
- Experimental data suggest aldosterone promotes fibroblast activation, but in vivo evidence of adrenocortical activity impacting myocardial remodeling is limited.
Purpose of the Study:
- To investigate the adrenal-cardiac axis in PA using dual-tracer PET/MR.
- To evaluate the relationship between adrenocortical function, aldosterone secretion, and myocardial fibroblast activation.
Main Methods:
- Integrated 68Ga-Pentixafor (CXCR4-targeted) and 68Ga-FAPI-04 (FAP-targeted) PET/MR in 82 participants (40 PA, 21 essential hypertension, 21 controls).
- Quantified adrenal CXCR4 and myocardial FAPI uptake, correlating with clinical and cardiac MR indices.
- Assessed changes in 8 APA patients post-adrenalectomy.
Main Results:
- Adrenal CXCR4 signal correlated with aldosterone burden and adverse left ventricular remodeling, independent of blood pressure.
- Myocardial 68Ga-FAPI-04 uptake was significantly higher in PA patients (55%) vs. controls (0%), localizing to the basal septum.
- Adrenal CXCR4 signal correlated with myocardial FAPI activity and cardiac remodeling markers, linked to aldosterone levels.
Conclusions:
- Dual-tracer PET/MR demonstrated a CXCR4-FAP-mediated adrenal-cardiac axis in PA.
- This axis highlights cross-talk between adrenocortical function and myocardial fibroblast activation beyond blood pressure.
- FAPI PET indicated more severe myocardial activation in APA, with partial reversibility post-surgery, emphasizing early diagnosis and intervention.
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