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JACC Cardiovasc Imaging. 2013 Aug;6(8):889-98. doi: 10.1016/j.jcmg.2013.04.010. Epub 2013 Jul 10.

Fat deposition in dilated cardiomyopathy assessed by CMR.

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  • 1Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Peoples Republic of China.

Abstract

OBJECTIVES:

The aim of this study was to prospectively investigate the prevalence of fat deposition in idiopathic dilated cardiomyopathy (DCM) by fat-water separation imaging. An auxiliary aim was to determine the relationship between left ventricular (LV) fat deposition and characteristic myocardial fibrosis, as well as cardiac functional parameters.

BACKGROUND:

Idiopathic DCM remains the most common cause of heart failure in young people referred for cardiac transplantation; little is known about the clinical value of fat deposition in DCM.

METHODS:

A total of 124 patients with DCM were studied after written informed consent was obtained. The magnetic resonance imaging scan protocols included a series of short-axis LV cine imaging for functional analysis, fat-water separation imaging, and late gadolinium enhancement (LGE) imaging. Fat deposition and fibrosis location were compared to the scar regions on LGE images using a 17-segment model. Statistical comparisons of LV global functional parameters, fibrosis volumes, and fat deposition were carried out using the Pearson correlation, Student t test, and multiple regressions.

RESULTS:

The patients had a 41.9% (52 of 124) prevalence of positive LGE, and 12.9% (16 of 124) fat deposition prevalence was found in this DCM cohort. The patients with fat deposition had larger LV end-diastolic volume (LVEDV) index (140.8 ± 20.2 ml/m(2) vs. 123.4 ± 15.8 ml/m(2); p < 0.01), larger LV end-systolic volume (LVESV) index (111.3 ± 19.2 ml/m(2) vs. 87.0 ± 20.3 ml/m(2); p < 0.01), and decreased LV ejection fraction (LVEF) (21.1 ± 7.1% vs. 30.0 ± 10.7%; p < 0.01). Higher volumes of LGE were found in the group with myocardial fat deposition (18.39 ± 9.0 ml vs. 13.40 ± 6.54 ml; p = 0.001), as well as a higher percentage of LGE/LV mass (19.11 ± 7.78% vs. 13.60 ± 4.58%; p = 0.000). The volume of fat deposition was correlated with scar volume, LVEF, LVEDV index, and LVESV index.

CONCLUSIONS:

Fat deposition is a common phenomenon in DCM, and it is associated with DCM characteristics such as fibrosis volume and LV function.

Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

CO; DCM; LGE; LV; LVEDV; LVEF; LVESV; LVM; MRI; cardiac output; dilated cardiomyopathy; fat deposition; late gadolinium enhancement; left ventricle/ventricular; left ventricular ejection fraction; left ventricular end-diastolic volume; left ventricular end-systolic volume; left ventricular mass; water-fat separation imaging

Comment in

  • Reply: in the footsteps of Virchow. [JACC Cardiovasc Imaging. 2014]
  • In the footsteps of Virchow. [JACC Cardiovasc Imaging. 2014]
PMID:
23850250
[PubMed - indexed for MEDLINE]
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