Noninvasive Assessment of Lipomatous Metaplasia as a Substrate for Ventricular Tachycardia in Chronic Infarct

Circ Cardiovasc Imaging. 2023 Aug;16(8):e014399. doi: 10.1161/CIRCIMAGING.123.014399. Epub 2023 Aug 1.

Abstract

Myocardial lipomatous metaplasia (LM) has been increasingly reported in patients with prior myocardial infarction. Cardiac magnetic resonance and cardiac contrast-enhanced computed tomography have been used to noninvasively detect and quantify myocardial LM in postinfarct patients, and may provide useful information for understanding cardiac mechanics, arrhythmia susceptibility, and prognosis. This review aims to summarize the advantages and disadvantages, clinical applications, and imaging features of different cardiac magnetic resonance sequences and cardiac contrast-enhanced computed tomography for LM detection and quantification. We also briefly summarize LM prevalence in different cohorts of postinfarct patients and review the clinical utility of cardiac imaging in exploring myocardial LM as an arrhythmogenic substrate in patients with prior myocardial infarction.

Keywords: adipocytes; intracellular space; metaplasia; myocardial infarction; myocardium.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Arrhythmias, Cardiac
  • Humans
  • Magnetic Resonance Imaging / methods
  • Metaplasia / pathology
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / diagnostic imaging
  • Myocardium / pathology
  • Tachycardia, Ventricular* / diagnosis
  • Tachycardia, Ventricular* / etiology