Document Detail

Ventricular myocardial fat: CT findings and clinical correlates.
MedLine Citation:
PMID:  17527115     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Replacement of the myocardium by fat is a feature of arrythmogenic right ventricular dysplasia (ARVD). Pathology literature describes ventricular myocardial fat to be present not only in ARVD, but much more frequently related to aging, prior myocardial infarction (MI), and chronic ischemia. We noted focal ventricular myocardial fat in a group of patients who underwent chest computed tomography (CT) for varied indications. The aim of this study is to describe the noncontrast CT findings and clinical correlates of ventricular myocardial fat in this population. MATERIALS AND METHODS: We prospectively identified 26 patients whose noncontrast chest CT (5/03 to 6/04) demonstrated ventricular myocardial fat and whose clinical charts were available. There were 14 men and 12 women with a mean age of 70 years. Twenty-three percent (6/26) had prior CTs. Each CT was reviewed by 3 radiologists in consensus. The site of the ventricular fat was noted. Each patient was categorized based on the location of the fat as follows: group 1-right ventricle (RV) only, group 2-left ventricle (LV) only, group 3-biventricular. Results of cardiac history, laboratory tests, and cardiac imaging were noted. RESULTS: The distribution of ventricular myocardial fat was: group 1 RV-27% (7/26), group 2 LV-46% (12/26), and group 3 biventricular-27% (7/26). Echocardiographic, nuclear cardiology, or electrocardiographic data localizing a prior MI to a specific site were available in 35% (9/26) of patients: 14% (1/7) of group 1, 50% (6/12) of group 2, and 29% (2/7) of group 3. Myocardial fat corresponded to the site of MI in 89% (8/9). The presence and distribution of ventricular fat on CT was unchanged from prior CT in 100% (6/6). When comparing group 1 and group 2, group 1 was older (77 vs. 64 y, P=0.005), more often female (57% vs. 17%, P=0.13) and had fewer prior MI (14% vs. 50%, P=0.17) than group 2. Only 1 patient in this series had ARVD. He was in group 3. CONCLUSIONS: The significance of ventricular myocardial fat varies by location. Fat in the RV is most often related to aging. Prior RV MI and ARVD are less common etiologies. Fat in the LV is frequently related to prior MI. Recognition of myocardial fat on a noncontrast chest CT may be the first opportunity to diagnose a silent MI.
Adam H Jacobi; Arash Gohari; Benjamin Zalta; Marjorie W Stein; Linda B Haramati
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thoracic imaging     Volume:  22     ISSN:  0883-5993     ISO Abbreviation:  J Thorac Imaging     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-28     Completed Date:  2007-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8606160     Medline TA:  J Thorac Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130-5     Citation Subset:  IM    
Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.
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MeSH Terms
Adipose Tissue / radiography*
Age Factors
Aged, 80 and over
Heart / radiography*
Heart Ventricles / radiography
Middle Aged
Myocardial Infarction / complications,  diagnosis
Observer Variation
Prospective Studies
Sex Factors
Tomography, X-Ray Computed / methods*

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