3D-Dixon cardiac magnetic resonance detects an increased epicardial fat volume in hypertensive men with myocardial infarction

Purpose: Using a three-dimensional ECG- and respiratory navigator gated magnetization prepared mDixon-sequence (3D-Dixon) we quantified epi- and pericardial fat volumes (EFV, PFV) in hypertensive men compared to a healthy control group and related the amount of fat volumes in hypertensive men to the presence of coronary artery disease (CAD) and myocardial infarction (MI).

Materials and methods: 55 hypertensive men (mean age 63.02±10.73years [y]) with MI (n=22; mean age 61.55±10.50y) and without MI (n=33; mean age 63.17±10.93y), and a group of ten healthy men (mean age 59.00±8.41y) underwent a comprehensive cardiomagnetic resonance (CMR) examination on a 1.5T MR system (Ingenia, Philips). Hypertensive men without MI consisted of patients with CAD (n=15) and without CAD (n=18). EFV and PFV were assessed using 3D-Dixon. Fat only images were reconstructed online at the scanner, and the segmentation of fat volumes was performed based on fat fraction maps. EFV and PFV were normalized to the body surface area (ml/m(2)).

Results: Mean EFV and PFV in all hypertensive men (81.8±33.90 and 194.86±83.51) as well as in hypertensive men with no CAD (74.53±26.40 and 174.60±65.70) were significantly higher than in the healthy controls (52.98±19.81 and 115.50±53.57; P<0.05, each). EFV and PFV in hypertensive men with MI (94.14±43.16 and 224.26±100.79) were significantly higher than in hypertensive men with no MI (73.57±23.27 and 175.26±63.07; P<0.05, each). There were no significant differences in age, BMI or heart rate between the groups.

Conclusion: 3D-Dixon measurements revealed significantly higher epi- and pericardial fat volumes in hypertensive men with myocardial infarction compared to hypertensive men without MI. This finding underscores the role of cardiac fatty tissue as a proinflammatory and metabolically active organ. Non-invasive CMR-based whole volume measurement of epi- and pericardial fat may play a relevant future role in cardiovascular risk stratification and disease management.