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Adipose Tissue Detected by Multislice Computed Tomography in Patients After Myocardial Infarction

Yasutaka Ichikawa, MD^_*,_*, Kakuya Kitagawa, MD, Shuji Chino, MD^_*, Masaki Ishida, MD, Koji Matsuoka, MD, Takashi Tanigawa, MD, Tomoaki Nakamura, MD, Tadanori Hirano, MD^_*, Kan Takeda, MD, Hajime Sakuma, MD

^_* Department of Radiology, Matsusaka Central Hospital, Mie, Japan
Department of Internal Medicine, Matsusaka Central Hospital, Mie, Japan
Department of Radiology, Mie University, Mie, Japan

^_* Reprint requests and correspondence: Dr. Yasutaka Ichikawa, Department of Radiology, Matsusaka Central Hospital, 102 Kobou, Kawai, Matsusaka, Mie 515-8566, Japan (Email: yasutaka{at}clin.medic.mie-u.ac.jp).

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 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 3 years. CT evaluation of myocardial adipose tissue may be important for accurate interpretation of CT perfusion and infarct imaging of the heart.

Key Words: myocardial infarction • lipomatous metaplasia • multislice computed tomography

Abbreviations and Acronyms   CT = computed tomography   LV = left ventricle/ventricular   MI = myocardial infarction   RV = right ventricle/ventricular