Multidetector computed tomography shows intramyocardial fat deposition

Background

Intramyocardial fat deposition occurs as an age-related process and in multiple pathologic processes.

Objective

We evaluated the presence of left ventricular (LV) and right ventricular (RV) intramyocardial fat with 64-slice multidetector computed tomography (MDCT).

Methods

One hundred persons with no history of coronary artery disease (47 women, 53 men; mean age [± SD], 53 ± 12.2 years) and 25 patients with CT findings of myocardial infarction (17 men, 8 women; mean age, 71.3 ± 9.6 years) were studied for intramyocardial fat in defined segments of the ventricles (17 LV and 10 RV segments) at 3 levels. Fat deposition was defined as density range of −30 to −190 Hounsfield units on images both before and after contrast.

Results

In healthy persons, LV intramyocardial fat was primarily located in the basal segments (5% anteroseptal, 5% inferior), and RV intramyocardial fat was primarily located in the anterolateral (24% of base, 23% of mid) and inferolateral (27% base, 27% mid) segments. Older age was associated with an increased odds of RV (sex-adjusted odds ratio [OR] per decade increment, 1.61; 95% confidence interval [CI], 1.11–2.33; P = 0.012) but not LV (OR, 0.97; 95% CI, 0.67–1.40; P = 0.85) intramyocardial fat. Compared with women, men had a lower risk of LV (95% CI, 0.1–0.64; P = 0.004) but not RV (95% CI, 0.35–1.87; P = 0.62) intramyocardial fat. Patients with old myocardial infarction (>3 years) had increased percentage of fat in infarcted left ventricles at all 3 levels (P ≤ 0.004).

Conclusions

Intramyocardial fat can be detected by MDCT and is common in healthy and infarcted myocardium.

Keywords: ARVD, arrhythmogenic right ventricular dysplasia, Myocardial fat, Myocardial infarction