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Organic cardiovascular disease (myocarditis, cardiomyopathy, congenital heart disease, rheumatic heart disease,valve)
Clinical characteristics of fat replacement of left ventricular myocardium
  1. Chaowu Yan1,
  2. Shihua Zhao1,
  3. Hua Li2,
  4. Shiliang Jiang1,
  5. Jian Ling1,
  6. Yan Zhang1
  1. 1Fuwai Hospital
  2. 2Beijing Tongren Hospital

Abstract

Objective To evaluate the clinical characteristics of left ventricular fat replacement.

Methods We identified 45 patients [28M/17F, mean age (51.9±14.7 )years] with left ventricular myocardial fat replacement (CT value ≤ −30 Hu) by cardiovascular CT.

Results Among 45 patients, 25 patients (20 M/5F, mean age (61.2±10.4) years) were diagnosed as coronary artery disease (CAD). There was 56%single-vessel disease, 20% double-vessel disease and 24%triple-vessel disease, true left ventricular aneurysm was detected in 3 patients and left ventricular thrombi in 1 patient, the dimension of left ventricle was (54.5±9.4) mm and the LVEF was (51.8±13)% in CAD group. In this group, fat replacement occurred in the region of myocardial infarction and presented as curvilinear band in subendocardial region. The left ventricular wall thickness was lower than 5 mm in 21 cases. The location of fat replacement in CAD group is as follows: apical region in 18 patients, distal septal in 15 patients, distal anterior in 11 patients, mid-septal in 7 patients, mid-anterior in 7 patients and basal in 1 patients. The age of remaining 20 patients (8 M/12 F) without CAD were (57.8±13.3) years. In the group of non-CAD, dilated cardiomyopathy was diagnosed in 3 patients, atrial septal defect in 1 patient, rheumatic heart disease in 1 patient, there was no structural heart disease in the remaining 15 patients. The dimension of left ventricle was (51.1±9.1) mm and the LVEF was (59.4±13.9) %. In non-CAD group, fat replacement mainly occurred in septal region, presented as curvilinear band in 17 patients and patch in 3 patients. The location of fat replacement in this group is as follows: mid-septal region in 11 patients, distal-septal in 10 patients and apical in 9 patients. The intramural fat replacement was detected in 14 patients: subendocardial fat replacement in 10 patients and both intramural and subendocardial fat replacement in 4 patients.

Conclusions Left ventricular fat replacement could be documented in CAD patients, non-CAD cardiomypathy patients and in patients without structural heart disease. Left ventricular fat replacement is often sited in the apical region in CAD patients as a consequence of infarct healing while mostly sited in septal region in non-CAD patients. The definite clinical implication of left ventricular fat replacement in non-CAD patients remains to be clarified.

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