Left ventricular fat deposition on CT in patients without proven myocardial disease

To analyze computed tomography (CT) characteristics of left ventricle (LV) fat deposition in patients without proven myocardial disease and to correlate these CT findings with electrocardiogram (ECG) and echocardiography data. We retrospectively searched our database of 14,470 consecutive coronary CT scans performed in the past 4 years for LV fat deposition in patients without proven myocardial disease. In total, we identified 25 patients (0.2 %; 10 males, 15 females; mean age 63 years) involving 91 cardiac segments. Pattern and location of LV fat deposition on CT were analyzed and compared to ECG and echocardiographic data. LV fat deposition can be categorized into 3 patterns: fat deposits in an apical cap (pattern I, n = 14), localized fat accumulation (pattern II, n = 12), and diffuse linear accumulation (pattern III, n = 6). Both patterns I and II were seen in 7 patients. The most common locations were apical segments (40 %) and the mid-myocardial layer (70 %). No patients had ECG findings positive for left-dominant arrhythmogenic dysplasia. Regional wall-motion abnormalities and decreased LV function (ejection fraction < 50 %) were only observed in 33 % of pattern III cases. LV fat deposition on CT can be seen in patients without proven myocardial disease. LV fat depositions were most commonly seen in the mid-myocardial location and apical segments. Diffuse linear fat deposition in the LV may correlates with decreased regional and global function.