Prevalence of fat deposition within the right ventricular myocardium in asymptomatic young patients without ventricular arrhythmias

Purpose: Variable amounts of intramyocardial fat can be found within the right ventricular muscle fibers. We aimed to determine the prevalence of intramyocardial fat deposition within the right ventricle (RV) in asymptomatic patients aged 40 years and younger who underwent imaging of the heart for coronary artery disease screening. Materials and Methods: Retrospective review of 540 consecutive patients aged 40 years or younger referred for coronary calcium scoring. Results: The images were reviewed by 2 dedicated cardiac radiologists, and the following specific observations were made: presence or absence of macroscopic fat in the RV by location, RV size as normal or enlarged, and presence of additional foci of fat deposition in the visualized thorax. The clinical data were reviewed from the patients' medical record, and the following information was recorded: age, sex, body mass index, and the presence of cardiac risk factors. The electrocardiographic examinations were reviewed as well. The study cohort included 398 males (73%) and 142 females (27%), with a mean age of 36.2±4.3 years and a range of 12 to 40 years. Sixty-two patients (11.5%) had macroscopic fatty deposition of the RV myocardium. Conclusions: Fatty replacement of the free wall of the RV is common, occurring in up to 11% of asymptomatic patients younger than 40 years of age undergoing cardiac screening examinations. No statistically significant association with cardiac risk factors or body mass index was found.