Skip to main content
SpringerLink
Log in

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

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Jugdutt BI, Amy RWM (1986) Healing after myocardial infarction in the changes in infarct hydroxyproline and topography. J Am Coll Cardiol 7:91–102

    Article  CAS  PubMed  Google Scholar 

  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 15:872–880

    Article  CAS  PubMed  Google Scholar 

  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 9:31–40

    Article  Google Scholar 

  4. Estornell J, Jimenez R, Ridocci F (2006) In vivo demonstration of lipomatous metaplasia in left ventricular scar following myocardial infarction. Eur Heart J 27:1766

    Article  PubMed  Google Scholar 

  5. Schmitt M, Samani N, McCann G (2007) Lipomatous metaplasia in ischemic cardiomyopathy—a common but unappreciated entity. Circulation 116:e5–e6

    Article  PubMed  Google Scholar 

  6. Arnold JR, Karamitsos TD, Pegg TJ, Francis JM, Neubauer S (2009) Left ventricular lipomatous metaplasia following myocardial infarction. Int J Cardiol 137:e11–2

    Article  PubMed  Google Scholar 

  7. Mallory GK, White PD, Salcedo-Salgar J (1939) The speed of healing of myocardial infarction. Am Heart J 18:647–671

    Article  Google Scholar 

  8. Caruso G, Frassanito F, Serio G, Penella A (1989) Is adipose tissue a normal component of the myocardium? Eur Heart J 10:89–91

    PubMed  Google Scholar 

  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 3:33–41

    Article  Google Scholar 

  10. Baroldi G, Dilver MD, De Maria R, Parodi O, Pellegrini A (1997) Lipomatous metaplasia in left ventricular scar. Can J Cardiol 13:65–71

    CAS  PubMed  Google Scholar 

  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 12:1222–1228

    Article  CAS  PubMed  Google Scholar 

  12. Fuchs F, Laub G, Othomo K (2003) TrueFISP—technical considerations and cardiovascular applications. Eur J Radiol 46:28–32

    Article  PubMed  Google Scholar 

  13. Su L, Siegel JE, Fishbein MC (2004) Adipose tissue in myocardial infarction. Cardiovasc Pathol 13:98–102

    Article  PubMed  Google Scholar 

  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 28:4

    Article  Google Scholar 

  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 29:570

    Article  PubMed  Google Scholar 

  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 105:539–542

    Article  PubMed  Google Scholar 

  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–e16

    Article  PubMed  Google Scholar 

  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 61:215–221

    Article  CAS  PubMed  Google Scholar 

  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 18:800–805

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Leipzig Heart Center/University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany

    Christian Lücke, Kathrin Schindler, Lukas Lehmkuhl, Matthias Grothoff & Matthias Gutberlet

  2. Department of Internal Medicine, Cardiology, Leipzig Heart Center/University of Leipzig, Leipzig, Germany

    Ingo Eitel, Gerhard Schuler & Holger Thiele

  3. Albers-Schönberg-Institut für Strahlendiagnostik, St. Georg-Hospital, Hamburg, Germany

    Dietmar Kivelitz

Authors
  1. Christian Lücke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathrin Schindler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lukas Lehmkuhl
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthias Grothoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ingo Eitel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gerhard Schuler
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Holger Thiele
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dietmar Kivelitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Matthias Gutberlet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian Lücke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lücke, C., Schindler, K., Lehmkuhl, L. et al. Prevalence and functional impact of lipomatous metaplasia in scar tissue following myocardial infarction evaluated by MRI. Eur Radiol 20, 2074–2083 (2010). https://doi.org/10.1007/s00330-010-1791-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-1791-x

Keywords

Search

Navigation