The Latest Progress of Targeting Fibroblast Activating Protein PET/CT Molecular Imaging in Heart Failure

Heart failure (HF), the devastating end-stage manifestation of numerous cardiovascular diseases, exhibits alarmingly high morbidity, recurrent hospitalization rates, and mortality. At the core of this pathology lies myocardial fibrosis. Early detection, precise classification, dynamic monitoring, and rigorous assessment of treatment response for myocardial fibrosis are crucial for advancing precision management of HF. In recent years, fibroblast activation protein (FAP)-targeted molecular imaging—specifically fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT)—has garnered considerable attention. This innovative technology uniquely enables the visualization and quantitative assessment of myocardial fibrosis at the molecular level. This review synthesizes the latest research progress on FAPI PET/CT in HF, emphasizing its promising potential for application in the early diagnosis, risk stratification, and prediction of outcomes related to myocardial fibrosis. It also critically examines existing technical limitations and explores prospects for future research.