Advertisement

European Radiology

, Volume 20, Issue 9, pp 2074–2083 | Cite as

Prevalence and functional impact of lipomatous metaplasia in scar tissue following myocardial infarction evaluated by MRI

  • Christian LückeEmail author
  • Kathrin Schindler
  • Lukas Lehmkuhl
  • Matthias Grothoff
  • Ingo Eitel
  • Gerhard Schuler
  • Holger Thiele
  • Dietmar Kivelitz
  • Matthias Gutberlet
Cardiac

Abstract

Objective

To retrospectively assess the prevalence and functional relevance of lipomatous metaplasia (LM) of the left ventricle in patients with chronic ischaemic heart disease (CIHD) using cardiac magnetic resonance imaging (cMRI) with steady state free precession (SSFP) sequences.

Methods

We examined 315 patients (248 male, mean age 63 ± 10 years) with a history of CIHD by cMRI. Standard SSFP sequences were applied and results were correlated with findings from cardiac catheterisation and computed tomography. In a subgroup of patients with LM (LM+) the functional results were correlated with patients without LM (LM−) as controls matched for age, body mass index, gender and infarct size.

Results

Of 315 patients, 36 showed LM. LM+ patients showed a higher tendency to develop aneurysms compared with LM− (31% vs. 17%; not significant), but no differences in ejection fraction or volumetric parameters. LM occurred significantly more often in older infarcts and patients with hyperlipoproteinaemia, while other cardiac risk factors or medication did not have a significant influence on the development of LM.

Conclusions

LM is a common finding (11%) in patients with CIHD. LM does not have a significant influence on global cardiac function or ventricular size, but on local function and probably also on the development of left ventricular aneurysms.

Keywords

Cardiovascular radiology Lipomatous metaplasia Myocardial infarction MRI CT 

References

  1. 1.
    Jugdutt BI, Amy RWM (1986) Healing after myocardial infarction in the changes in infarct hydroxyproline and topography. J Am Coll Cardiol 7:91–102CrossRefPubMedGoogle Scholar
  2. 2.
    Gutberlet M, Fröhlich M, Mehl S et al (2005) Myocardial viability assessment in patients with highly impaired left ventricular function: comparison of delayed enhancement, dobutamine stress MRI, end-diastolic wall thickness, and TI201-SPECT with functional recovery after revascularization. Eur Radiol 15:872–880CrossRefPubMedGoogle Scholar
  3. 3.
    Sechtem U, Voth E, Baer F, Schneider C, Theissen P, Schicha H (1993) Assessment of residual viability in patients with myocardial infarction using magnetic resonance techniques. Int J Cardiac Imaging 9:31–40CrossRefGoogle Scholar
  4. 4.
    Estornell J, Jimenez R, Ridocci F (2006) In vivo demonstration of lipomatous metaplasia in left ventricular scar following myocardial infarction. Eur Heart J 27:1766CrossRefPubMedGoogle Scholar
  5. 5.
    Schmitt M, Samani N, McCann G (2007) Lipomatous metaplasia in ischemic cardiomyopathy—a common but unappreciated entity. Circulation 116:e5–e6CrossRefPubMedGoogle Scholar
  6. 6.
    Arnold JR, Karamitsos TD, Pegg TJ, Francis JM, Neubauer S (2009) Left ventricular lipomatous metaplasia following myocardial infarction. Int J Cardiol 137:e11–2CrossRefPubMedGoogle Scholar
  7. 7.
    Mallory GK, White PD, Salcedo-Salgar J (1939) The speed of healing of myocardial infarction. Am Heart J 18:647–671CrossRefGoogle Scholar
  8. 8.
    Caruso G, Frassanito F, Serio G, Penella A (1989) Is adipose tissue a normal component of the myocardium? Eur Heart J 10:89–91PubMedGoogle Scholar
  9. 9.
    Debinski AS, Bobson JR, Wilson JA et al (1994) Frequency, extent and distribution of endomyocardial adipose tissue: morphometric analysis of endomyocardial biopsy specimens from 241 patients. Cardiovasc Pathol 3:33–41CrossRefGoogle Scholar
  10. 10.
    Baroldi G, Dilver MD, De Maria R, Parodi O, Pellegrini A (1997) Lipomatous metaplasia in left ventricular scar. Can J Cardiol 13:65–71PubMedGoogle Scholar
  11. 11.
    Nava A, Thiene G, Canciani B et al (1988) Familial occurrence of right ventricular dysplasia: a study involving nine families. J Am Coll Cardiol 12:1222–1228CrossRefPubMedGoogle Scholar
  12. 12.
    Fuchs F, Laub G, Othomo K (2003) TrueFISP—technical considerations and cardiovascular applications. Eur J Radiol 46:28–32CrossRefPubMedGoogle Scholar
  13. 13.
    Su L, Siegel JE, Fishbein MC (2004) Adipose tissue in myocardial infarction. Cardiovasc Pathol 13:98–102CrossRefPubMedGoogle Scholar
  14. 14.
    Winer-Muram HT, Tann M, Aisen AM, Ford L, Jennings SG, Bretz R (2004) Computed tomography demonstration of lipomatous metaplasia of the left ventricle following myocardial infarction. J Comput Assist Tomogr 28:4CrossRefGoogle Scholar
  15. 15.
    Deux JF, Rahmouni A, Garot J (2008) Cardiac magnetic resonance and 64-slice cardiac CT off lipomatous metaplasia of chronic myocardial infarction. Eur Heart J 29:570CrossRefPubMedGoogle Scholar
  16. 16.
    Cerqueira MD, Weissman NJ, Dilsizian V et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A Statement for Healthcare Professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542CrossRefPubMedGoogle Scholar
  17. 17.
    Wu YW, Tadamura E, Yamamuro M et al (2007) Identification of lipomatous metaplasia in old infarcted myocardium by cardiovascular magnetic resonance and computed tomography. Int J Cardiol 115:e15–e16CrossRefPubMedGoogle Scholar
  18. 18.
    Kellman P, Hernando D, Shah S et al (2009) Multiecho Dixon fat and water separation method for detecting fibrofatty infiltration in the myocardium. Magn Reson Med 61:215–221CrossRefPubMedGoogle Scholar
  19. 19.
    O’Regan DP, Callaghan MF, Fitzpatrick J, Naoumova RP, Hajnal JV, Schmitz SA (2008) Cardiac T2* and lipid measurement at 3.0 T—initial experience. Eur Radiol 18:800–805CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Christian Lücke
    • 1
    Email author
  • Kathrin Schindler
    • 1
  • Lukas Lehmkuhl
    • 1
  • Matthias Grothoff
    • 1
  • Ingo Eitel
    • 2
  • Gerhard Schuler
    • 2
  • Holger Thiele
    • 2
  • Dietmar Kivelitz
    • 3
  • Matthias Gutberlet
    • 1
  1. 1.Department of Diagnostic and Interventional RadiologyLeipzig Heart Center/University of LeipzigLeipzigGermany
  2. 2.Department of Internal Medicine, CardiologyLeipzig Heart Center/University of LeipzigLeipzigGermany
  3. 3.Albers-Schönberg-Institut für StrahlendiagnostikSt. Georg-HospitalHamburgGermany

Personalised recommendations