Adipose tissue detected by multislice computed tomography in patients after myocardial infarction.

OBJECTIVES Our aim was to investigate the frequency of left ventricular (LV) and right ventricular adipose tissue on multislice computed tomography (CT) in patients with a history of myocardial infarction (MI) and to determine correlations with infarct age. BACKGROUND Fat deposition in the ventricular wall has frequently been observed in post-infarct myocardial tissue. However, the in vivo relevance of adipose tissue in MI on CT and correlations with infarct age have not been determined. METHODS Fifty-three patients with a history of MI (mean age 66 +/- 10 years; 38 men, 15 women) and 63 subjects with no history of MI or coronary revascularization (mean age 65 +/- 12 years; 37 men, 26 women) were retrospectively studied for intramyocardial fat on 64-slice cardiac CT. Presence or absence, distribution, and correlations with infarct age of LV adipose tissue were evaluated. RESULTS Compared with noninfarct control subjects, the MI group showed a significantly higher prevalence of fat deposition within LV myocardium on CT (MI group, 62% [33 of 53] vs. control group, 3% [2 of 63]; p < 0.0001). In 32 of 33 patients (97%) with MI and LV fat deposition on CT, adipose tissue was observed in the region perfused by the infarct-related artery and was located in the subendocardium in 30 patients (94%), the middle layer in 1 patient (3%), and the subepicardium in 1 patient (3%). Mean infarct age was significantly higher in patients with LV adipose tissue (8.2 +/- 4.4 years) than in those without adipose tissue (2.2 +/- 2.6 years, p < 0.001). Thirty of 35 patients (89%) with infarct age >or=3 years showed adipose tissue in MI. Conversely, none of 9 patients with infarct age <10 months showed fatty replacement. CONCLUSIONS Myocardial adipose tissue is common in patients with infarct age >or=3 years. CT evaluation of myocardial adipose tissue may be important for accurate interpretation of CT perfusion and infarct imaging of the heart.

[1]  K. Murase,et al.  Quantification of myocardial perfusion by contrast-enhanced 64-MDCT: characterization of ischemic myocardium. , 2008, AJR. American journal of roentgenology.

[2]  Jörg Hausleiter,et al.  Non-invasive coronary computed tomographic angiography for patients with suspected coronary artery disease: the Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial. , 2007, European heart journal.

[3]  O Parodi,et al.  Lipomatous metaplasia in left ventricular scar. , 1997, The Canadian journal of cardiology.

[4]  Wan-Chun Liao,et al.  Comprehensive evaluation of ischemic heart disease using MDCT. , 2008, AJR. American journal of roentgenology.

[5]  Marco Valgimigli,et al.  Diagnostic performance of multislice spiral computed tomography of coronary arteries as compared with conventional invasive coronary angiography: a meta-analysis. , 2006, Journal of the American College of Cardiology.

[6]  C. Caussin,et al.  Acute myocardial infarction early viability assessment by 64-slice computed tomography immediately after coronary angiography: comparison with low-dose dobutamine echocardiography. , 2007, Journal of the American College of Cardiology.

[7]  J. Goldfarb,et al.  T1‐weighted magnetic resonance imaging shows fatty deposition after myocardial infarction , 2007, Magnetic resonance in medicine.

[8]  L. Haramati,et al.  Ventricular Myocardial Fat: CT Findings and Clinical Correlates , 2007, Journal of thoracic imaging.

[9]  N. Paul,et al.  Perioperative β-Blockers : Use With Caution Perioperative β Blockers in Patients Having Non-Cardiac Surgery : A Meta-Analysis , 2010 .

[10]  Henry R. Halperin,et al.  Contrast-Enhanced Multidetector Computed Tomography Viability Imaging After Myocardial Infarction: Characterization of Myocyte Death, Microvascular Obstruction, and Chronic Scar , 2006, Circulation.

[11]  Y. Akiyama,et al.  Variability of repeated coronary artery calcium measurements on low-dose ECG-gated 16-MDCT. , 2006, AJR. American journal of roentgenology.

[12]  J. Glockner,et al.  Focal macroscopic fat deposition within the right ventricular wall in asymptomatic patients undergoing screening EBCT coronary calcium scoring examinations , 2008, The International Journal of Cardiovascular Imaging.

[13]  A. Aisen,et al.  Computed tomography demonstration of lipomatous metaplasia of the left ventricle following myocardial infarction. , 2004, Journal of computer assisted tomography.

[14]  M. Budoff,et al.  Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Indi , 2008, Journal of the American College of Cardiology.

[15]  Walter Heindel,et al.  Assessment of regional left ventricular function with multidetector-row computed tomography versus magnetic resonance imaging , 2007, European Radiology.

[16]  M. Fishbein,et al.  Adipose tissue in myocardial infarction. , 2004, Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology.

[17]  H. Calkins,et al.  Magnetic resonance imaging of arrhythmogenic right ventricular dysplasia: sensitivity, specificity, and observer variability of fat detection versus functional analysis of the right ventricle. , 2006, Journal of the American College of Cardiology.

[18]  H. Calkins,et al.  Role of magnetic resonance imaging in arrhythmogenic right ventricular dysplasia: insights from the North American arrhythmogenic right ventricular dysplasia (ARVD/C) study. , 2008, American heart journal.

[19]  J. Lie.  Histopathology of the conduction system in sudden death from coronary heart disease. , 1975, Circulation.

[20]  R. Cury,et al.  Differentiation of recent and chronic myocardial infarction by cardiac computed tomography. , 2006, The American journal of cardiology.

[21]  Udo Hoffmann,et al.  Reperfused myocardial infarction: contrast-enhanced 64-Section CT in comparison to MR imaging. , 2008, Radiology.

[22]  B. Han,et al.  Right Ventricular Fat Infiltration in Asymptomatic Subjects: Observations from ECG-gated 16-slice Multidetector CT , 2007, Journal of computer assisted tomography.

[23]  H I Litt,et al.  CT imaging features and frequency of left ventricular myocardial fat in patients with CT findings of chronic left ventricular myocardial infarction. , 2008, Clinical radiology.

[24]  R. Cury,et al.  Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT. , 2008, Radiology.

[25]  D. Corrado,et al.  Quantitative assessment of endomyocardial biopsy in arrhythmogenic right ventricular cardiomyopathy/dysplasia: an in vitro validation of diagnostic criteria. , 2008, European heart journal.