{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:09:07Z","timestamp":1786691347377,"version":"build-2736575974"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum W\u00fcrzburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Acute myocardial infarction (AMI) triggers local inflammation in the injured myocardium, followed by a systemic inflammatory response of lymphatic organs. This prospective trial (NCT05519735) focused on molecular imaging of lymphatic organs (spleen, bone marrow, and heart-draining lymph nodes) and aimed to determine whether uptake in such remote organs identifies individuals predisposed to functional recovery during follow-up after AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      41 timely re-perfused ST-elevation AMI patients received baseline C-X-C motif chemokine receptor 4 directed\n                      <jats:sup>68<\/jats:sup>\n                      Ga-PentixaFor PET, a radiotracer targeting a broad spectrum of leukocytes. To determine left ventricular ejection fraction (LVEF) and infarct size, cardiac magnetic resonance imaging was conducted at baseline and repeated after six (follow-up (FU) 1, available in 38\/41) and twelve months (FU 2, available in 36\/41). As endpoint, an LVEF increase of \u2265\u20095% relative to baseline was defined as short- (at FU 1) and long-term functional (at FU 2) recovery. We also determined association of\n                      <jats:sup>68<\/jats:sup>\n                      Ga-PentixaFor uptake in lymphatic organs with outcome relative to established clinical and imaging biomarkers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LVEF at baseline was 50.4\u2009\u00b1\u20098.7% (range 34\u201365%). At FU 1, LVEF improved significantly (54.2\u2009\u00b1\u20097.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0004 vs. baseline) and the endpoint was recorded in 21\/38 patients. Univariate analysis identified baseline LVEF (Odds Ratio (OR), 0.80,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) and uptake derived from heart-draining lymph nodes (OR, 0.21,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03) as predictor of functional recovery, while only LVEF reached significance at multivariate analysis (OR, 0.72,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007). At FU 2, LVEF also improved to 54.3\u2009\u00b1\u20097.3% relative to baseline (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006) and the endpoint was met in 21\/36 patients. Baseline LVEF (OR 0.84,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) and splenic PET signal (OR, 2.46,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04) provided prognostic value at univariate analysis. Both parameters remained significant at multivariate outcome analysis (LVEF: OR, 0.73,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01; spleen: OR, 4.17,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04), indicating that baseline LVEF and splenic uptake are prognostic for improved long-term functional outcome. Established risk factors of cardiac damage (infarct size) or inflammation (C-reactive protein, white blood cell counts) failed to reach significance for functional recovery at both follow-up time-points.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inflammatory imaging in lymphatic organs may provide a complementary in-vivo biomarker for functional recovery and seems to be more strongly associated with outcome relative to standard markers of cardiac damage or inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07809-2","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:36:11Z","timestamp":1773210971000},"page":"4700-4707","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Molecular imaging of lymphatic organs provides prognostic value after acute myocardial infarction"],"prefix":"10.1007","volume":"53","author":[{"given":"Theresa","family":"Reiter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Lena","family":"D\u00f6rrler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Hasenauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian E.","family":"Serfling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Kraus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang R.","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willibald","family":"Hochholzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Samnick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Hofmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Frantz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas K.","family":"Buck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Kosmala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3372-6046","authenticated-orcid":false,"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"7809_CR1","doi-asserted-by":"publisher","first-page":"2497","DOI":"10.1056\/NEJMoa1912388","volume":"381","author":"JC Tardif","year":"2019","unstructured":"Tardif JC, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, et al. 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The study was approved by the ethical committee of the University Hospital W\u00fcrzburg (#192\/21).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Participants consented to imaging procedures, as well as to potential scientific analyses.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"RAW received speaker honoraria from Novartis\/AAA and PentixaPharm and reports advisory board work for Novartis\/AAA and Bayer.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"medRxiv 2025.09.04.25334995.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Published as preprint"}}]}}