February 16, 2009

Subendocardial Fat in Myocardial Infarction

Fig: Axial contrast-enhanced CT image shows a curvilinear low attenuation in the subendocardial portion of the left anterior descending (LAD) coronary artery territory of the left ventricle. The patient had a history of remote myocardial infarction (MI).

Myocardial Fat

  • Common entity, found histologically in 68% of ischemic heart disease patients and 84% of patients with history of MI.
  • May result from inability of ischemic myocytes to metabolize fatty acids.
  • Can be shown on cardiac MRI and CT.
  • In one study, it was detected in 22% of cases and it was most commonly seen in LAD territory.

What does it mean?
  • It is associated with greater infarct age
  • Patients with myocardial fat had more severe regional wall motion abnormalities on echocardiography
Ahn SS, et al. CT detection of subendocardial fat in myocardial infarction. AJR 2009;192:532-537.

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