title: Fat deposition in dilated cardiomyopathy assessed by CMR.
abstract: OBJECTIVE
  The aim of this study was to prospectively investigate the prevalence of fat deposition in idiopathic dilated cardiomyopathy (DCM) by fat-water separation imaging. An auxiliary aim was to determine the relationship between left ventricular (LV) fat deposition and characteristic myocardial fibrosis, as well as cardiac functional parameters.
  
  
  BACKGROUND
  Idiopathic DCM remains the most common cause of heart failure in young people referred for cardiac transplantation; little is known about the clinical value of fat deposition in DCM.
  
  
  METHODS
  A total of 124 patients with DCM were studied after written informed consent was obtained. The magnetic resonance imaging scan protocols included a series of short-axis LV cine imaging for functional analysis, fat-water separation imaging, and late gadolinium enhancement (LGE) imaging. Fat deposition and fibrosis location were compared to the scar regions on LGE images using a 17-segment model. Statistical comparisons of LV global functional parameters, fibrosis volumes, and fat deposition were carried out using the Pearson correlation, Student t test, and multiple regressions.
  
  
  RESULTS
  The patients had a 41.9% (52 of 124) prevalence of positive LGE, and 12.9% (16 of 124) fat deposition prevalence was found in this DCM cohort. The patients with fat deposition had larger LV end-diastolic volume (LVEDV) index (140.8 ± 20.2 ml/m(2) vs. 123.4 ± 15.8 ml/m(2); p < 0.01), larger LV end-systolic volume (LVESV) index (111.3 ± 19.2 ml/m(2) vs. 87.0 ± 20.3 ml/m(2); p < 0.01), and decreased LV ejection fraction (LVEF) (21.1 ± 7.1% vs. 30.0 ± 10.7%; p < 0.01). Higher volumes of LGE were found in the group with myocardial fat deposition (18.39 ± 9.0 ml vs. 13.40 ± 6.54 ml; p = 0.001), as well as a higher percentage of LGE/LV mass (19.11 ± 7.78% vs. 13.60 ± 4.58%; p = 0.000). The volume of fat deposition was correlated with scar volume, LVEF, LVEDV index, and LVESV index.
  
  
  CONCLUSIONS
  Fat deposition is a common phenomenon in DCM, and it is associated with DCM characteristics such as fibrosis volume and LV function.
authors.affiliation: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Peoples Republic of China.
authors.forename: Minjie
authors.initials: M
authors.lastname: Lu
authors.forename: Shihua
authors.initials: S
authors.lastname: Zhao
authors.forename: Shiliang
authors.initials: S
authors.lastname: Jiang
authors.forename: Gang
authors.initials: G
authors.lastname: Yin
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Qiong
authors.initials: Q
authors.lastname: Liu
authors.forename: Huaibing
authors.initials: H
authors.lastname: Cheng
authors.forename: Ning
authors.initials: N
authors.lastname: Ma
authors.forename: Tao
authors.initials: T
authors.lastname: Zhao
authors.forename: Xiuyu
authors.initials: X
authors.lastname: Chen
authors.forename: Jinghan
authors.initials: J
authors.lastname: Huang
authors.forename: Yubao
authors.initials: Y
authors.lastname: Zou
authors.forename: Lei
authors.initials: L
authors.lastname: Song
authors.forename: Zuoxiang
authors.initials: Z
authors.lastname: He
authors.forename: Jing
authors.initials: J
authors.lastname: An
authors.forename: Jerecic
authors.initials: J
authors.lastname: Renate
authors.forename: Hui
authors.initials: H
authors.lastname: Xue
authors.forename: Saurabh
authors.initials: S
authors.lastname: Shah
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000473:pathology* / Q000503:physiopathology; D003287:Contrast Media; D005260:Female; D005355:Fibrosis; D019786:Gadolinium DTPA; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: CO; DCM; LGE; LV; LVEDV; LVEF; LVESV; LVM; MRI; cardiac output; dilated cardiomyopathy; fat deposition; late gadolinium enhancement; left ventricle/ventricular; left ventricular ejection fraction; left ventricular end-diastolic volume; left ventricular end-systolic volume; left ventricular mass; water-fat separation imaging