Ventricular Myocardial Fat: An Unexpected Biomarker for Long-term Survival?
Eur Radiol
; 29(1): 241-250, 2019 Jan.
Article
en En
| MEDLINE
| ID: mdl-29948081
ABSTRACT
PURPOSE:
To examine the association between myocardial fat, a poorly understood finding frequently observed on non-contrast CT, and all-cause mortality in patients with and without a history of prior MI. MATERIALS ANDMETHODS:
A retrospective cohort from a diverse urban academic center was derived from chronic myocardial infarction (MI) patients (n = 265) and three age-matched patients without MI (n = 690) who underwent non-contrast chest CT between 1 January 2005-31 December 2008. CT images were reviewed for left and right ventricular fat. Electronic records identified clinical variables. Kaplan-Meier and Cox proportional hazard analyses assessed the association between myocardial fat and all-cause mortality. The net reclassification improvement assessed the utility of adding myocardial fat to traditional risk prediction models.RESULTS:
Mortality was 40.1% for the no MI and 71.7% for the MI groups (median follow-up, 6.8 years; mean age, 73.7 ± 10.6 years). In the no MI group, 25.7% had LV and 49.9% RV fat. In the MI group, 32.8% had LV and 42.3% RV fat. LV and RV fat was highly associated (OR 5.3, p < 0.001). Ventricular fat was not associated with cardiovascular risk factors. Myocardial fat was associated with a reduction in the adjusted hazard of death for both the no MI (25%, p = 0.04) and the MI group (31%, p = 0.018). Myocardial fat resulted in the correct reclassification of 22% for the no MI group versus the Charlson score or calcium score (p = 0.004) and 47% for the MI group versus the Charlson score (p = 0.0006).CONCLUSIONS:
Patients with myocardial fat have better survival, regardless of MI status, suggesting that myocardial fat is a beneficial biomarker and may improve risk stratification. KEY POINTS ⢠Myocardial fat is commonly found on chest CT, yet is poorly understood ⢠Myocardial fat is associated with better survival in patients with and without prior MI and is not associated with traditional cardiovascular risk factors ⢠This finding may provide clinically meaningful prognostic value in the risk stratification of patients.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Tejido Adiposo
/
Ventrículos Cardíacos
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Infarto del Miocardio
Tipo de estudio:
Etiology_studies
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Incidence_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos