Journal of Cardiovascular Computed Tomography (2008) 2, 152-163

Multidetector computed tomography shows intramyocardial fat deposition

Aidan R. Raney, MD, Farhood Saremi, MD*, Satish Kenchaiah, MD, Swaminatha V. Gurudevan, MD, Jagat Narula, MD, Navneet Narula, MD, Stephanie Channual, BS

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) in-tramyocardial 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