Advertisement

Japanese Journal of Radiology

, Volume 31, Issue 7, pp 444–454 | Cite as

CT features of myocardial fat and correlation with clinical background in patients without cardiac disease

  • Yuka Matsuo
  • Fumiko KimuraEmail author
  • Takatomo Nakajima
  • Kaiji Inoue
  • Waka Mizukoshi
  • Eito Kozawa
  • Fumikazu Sakai
Original Article
  • 169 Downloads

Abstract

Objective

To evaluate the frequency and common locations of myocardial fat and its associated factors using coronary CT angiography (CCTA) in patients without cardiac disease.

Methods

Using CCTA findings for 298 consecutive patients without cardiac disease, we categorized the myocardium into nine locations, scored fat in those locations, and correlated the fat score with the thickness of the right ventricular (RV) free wall and factors including gender, age, and body mass index (BMI) as well as history of diabetes mellitus, hypertension (HT), and dyslipidemia.

Results

We observed myocardial fat in 68.5 % of patients, most commonly in the RV outflow tract (RVOT, 64.1 %), followed by the base (42.3 %) and middle (28.9 %) of the RV free wall, RV trabeculations (22.5 %), and the left ventricular apex (11.4 %). The RV free wall thickened significantly with increasing fat score. Dependent variables for myocardial fat were female gender (P < 0.0001), age ≥65 years (P = 0.0043), BMI ≥25 (P = 0.0050), and HT (P = 0.0139).

Conclusion

Myocardial fat is a common finding on CCTA in patients without cardiac disease, is often observed in the RVOT, and is more frequent in female patients, those older than 65 years, those with BMI ≥25, and those with HT.

Keywords

Heart Myocardium Multidetector-row computed tomography Physiological state Adipose tissue 

Notes

Acknowledgments

We thank Mr. Shin Takahashi for his assistance with statistical analysis and Ms. Rosalyn Uhrig for her English proofreading.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Hamada S, Takamiya M, Ohe T, Ueda H. Arrhythmogenic right ventricular dysplasia: evaluation with electron-beam CT. Radiology. 1993;187:723–7.PubMedGoogle Scholar
  2. 2.
    Winkens MH, Snoep G, Bekkers SC. Images in cardiovascular medicine: imaging of arrhythmogenic right ventricular cardiomyopathy. Circulation. 2008;118:e158–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Kimura F, Sakai F, Sakomura Y, et al. Helical CT features of arrhythmogenic right ventricular cardiomyopathy. Radiographics. 2002;22:1111–24.PubMedGoogle Scholar
  4. 4.
    Tandri H, Bomma C, Calkins H, Bluemke DA. Magnetic resonance and computed tomography imaging of arrhythmogenic right ventricular dysplasia. J Magn Reson Imaging. 2004;19:848–58.PubMedCrossRefGoogle Scholar
  5. 5.
    Corrado D, Basso C, Thiene G, et al. Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. J Am Coll Cardiol. 1997;30:1512–20.PubMedCrossRefGoogle Scholar
  6. 6.
    d’Amati G, Leone O, di Gioia CR, et al. Arrhythmogenic right ventricular cardiomyopathy: clinicopathologic correlation based on a revised definition of pathologic patterns. Hum Pathol. 2001;32:1078–86.PubMedCrossRefGoogle Scholar
  7. 7.
    Winer-Muram HT, Tann M, Aisen AM, Ford L, Jennings SG, Bretz R. Computed tomography demonstration of lipomatous metaplasia of the left ventricle following myocardial infarction. J Comput Assist Tomogr. 2004;28:455–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Ahn SS, Kim YJ, Hur J, et al. CT detection of subendocardial fat in myocardial infarction. AJR Am J Roentgenol. 2009;192:532–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Ichikawa Y, Kitagawa K, Chino S, et al. Adipose tissue detected by multislice computed tomography in patients after myocardial infarction. JACC Cardiovasc Imaging. 2009;2:548–55.PubMedCrossRefGoogle Scholar
  10. 10.
    Zafar HM, Litt HI, Torigian DA. CT imaging features and frequency of left ventricular myocardial fat in patients with CT findings of chronic left ventricular myocardial infarction. Clin Radiol. 2008;63:256–62.PubMedCrossRefGoogle Scholar
  11. 11.
    Baroldi G, Silver MD, De Maria R, Parodi O, Pellegrini A. Lipomatous metaplasia in left ventricular scar. Can J Cardiol. 1997;13:65–71.PubMedGoogle Scholar
  12. 12.
    Sanal HT, Kocaoğlu M, Yildirim D, Ors F. Multiple cardiac lipomas and pericardial lipomatosis: multidetector-row computer tomography findings. Int J Cardiovasc Imaging. 2007;23:655–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Sparrow PJ, Kurian JB, Jones TR, Sivananthan MU. MR imaging of cardiac tumors. Radiographics. 2005;25:1255–76.PubMedCrossRefGoogle Scholar
  14. 14.
    Meaney JF, Kazerooni EA, Jamadar DA, Korobkin M. CT appearance of lipomatous hypertrophy of the interatrial septum. AJR Am J Roentgenol. 1997;168:1081–4.PubMedCrossRefGoogle Scholar
  15. 15.
    Adriaensen ME, Schaefer-Prokop CM, Duyndam DA, Zonnenberg BA, Prokop M. Fatty foci in the myocardium in patients with tuberous sclerosis complex: common finding at CT. Radiology. 2009;253:359–63.PubMedCrossRefGoogle Scholar
  16. 16.
    Perloff JK, de Leon AC, O’Doherty D Jr. The cardiomyopathy of progressive muscular dystrophy. Circulation. 1966;33:625–48.PubMedCrossRefGoogle Scholar
  17. 17.
    Hunter S. The heart in muscular dystrophy. Br Med Bull. 1980;36:133–4.PubMedGoogle Scholar
  18. 18.
    Kaminaga T, Naito H, Takamiya M, Hamada S, Nishimura T. Myocardial damage in patients with dilated cardiomyopathy: CT evaluation. J Comput Assist Tomogr. 1994;18:393–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Rakar S, Sinagra G, Di Lenarda A, et al. Epidemiology of dilated cardiomyopathy: a prospective post-mortem study of 5252 necropsies. The Heart Muscle Disease Study Group. Eur Heart J. 1997;18:117–23.PubMedCrossRefGoogle Scholar
  20. 20.
    Tansey DK, Aly Z, Sheppard MN. Fat in the right ventricle of the normal heart. Histopathology. 2005;46:98–104.PubMedCrossRefGoogle Scholar
  21. 21.
    Lorin de la Grandmaison G, Le Bihan C, Durigon M. Assessment of right ventricular lipomatosis by histomorphometry in control adult autopsy cases. Int J Legal Med. 2001;115:105–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Basso C, Thiene G. Adipositascordis, fatty infiltration of the right ventricle, and arrhythmogenic right ventricular cardiomyopathy: Just a matter of fat? Cardiovasc Pathol. 2005;14:37–41.PubMedCrossRefGoogle Scholar
  23. 23.
    Burke AP, Farb A, Tashko G, Virmani R. Arrhythmogenic right ventricular cardiomyopathy and fatty replacement of the right ventricular myocardium: are they different diseases? Circulation. 1998;97:1571–80.PubMedCrossRefGoogle Scholar
  24. 24.
    Kim E, Choe YH, Han BK, et al. Right ventricular fat infiltration in asymptomatic subjects: observations from ECG-gated 16-slice multidetector CT. J Comput Assist Tomogr. 2007;31:22–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Imada M, Funabashi N, Asano M, et al. Epidemiology of fat replacement of the right ventricular myocardium determined by multislice computed tomography using a logistic regression model. Int J Cardiol. 2007;119:410–3.PubMedCrossRefGoogle Scholar
  26. 26.
    Kirsch J, Williamson EE, Glockner JF. Focal macroscopic fat deposition within the right ventricular wall in asymptomatic patients undergoing screening EBCT coronary calcium scoring examinations. Int J Cardiovasc Imaging. 2008;24:223–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Abbara S, Arbab-Zadeh A, Callister TQ, et al. SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr. 2009;3:190–204.PubMedCrossRefGoogle Scholar
  28. 28.
    Jacobi AH, Gohari A, Zalta B, Stein MW, Haramati LB. Ventricular myocardial fat: CT findings and clinical correlates. J Thorac Imaging. 2007;22:130–5.PubMedCrossRefGoogle Scholar
  29. 29.
    Kimura F, Matsuo Y, Nakajima T, et al. Myocardial fat at cardiac CT: how can we differentiate pathologic from physiologic fatty infiltration? Radiographics. 2010;30:1587–602.PubMedCrossRefGoogle Scholar
  30. 30.
    Su L, Siegel JE, Fishbein MC. Adipose tissue in myocardial infarction. Cardiovasc Pathol. 2004;13:98–102.PubMedCrossRefGoogle Scholar
  31. 31.
    Goldfarb JW, Roth M, Han J. Myocardial fat deposition after left ventricular myocardial infarction: assessment by using MR water-fat separation imaging. Radiology. 2009;253:65–73.PubMedCrossRefGoogle Scholar
  32. 32.
    Taylor AJ, Cerqueira M, Hodgson JM, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol. 2010;56:1864–94.Google Scholar

Copyright information

© Japan Radiological Society 2013

Authors and Affiliations

  • Yuka Matsuo
    • 1
    • 2
  • Fumiko Kimura
    • 1
    Email author
  • Takatomo Nakajima
    • 3
  • Kaiji Inoue
    • 4
  • Waka Mizukoshi
    • 1
  • Eito Kozawa
    • 1
  • Fumikazu Sakai
    • 1
  1. 1.Department of Diagnostic RadiologySaitama Medical University International Medical CenterHidakaJapan
  2. 2.Department of Diagnostic Imaging and Nuclear MedicineTokyo Women’s Medical UniversityShinju-kuJapan
  3. 3.Department of CardiologySaitama Prefectural Circulatory and Respiratory CenterKumagayaJapan
  4. 4.Department of RadiologySaitama Medical University HospitalIruma-gunJapan

Personalised recommendations