Evolving role of molecular imaging for new understanding: targeting myofibroblasts to predict remodeling.

Containment of the process of cardiac remodeling is a prerequisite for prevention of development of heart failure (HF) after myocardial infarction. For personalization of therapeutic intervention strategy, it may be of benefit to identify the subset of patients who are at higher risk for development of HF. One such strategy may involve targeted imaging of various components involved in the remodeling process and interstitial fibrosis, including the myofibroblast. This cell type combines characteristics of fibroblasts and smooth muscle cells, and plays a crucial role in infarct healing and scar contraction. We define molecular targets on myofibroblasts and discuss the feasibility of molecular imaging of these cells for early detection and treatment of patients at risk for development of HF after myocardial infarction.