Tuesday, November 29 | 3:40 p.m.-3:50 p.m. | SSJ04-05 | Room S504AB
Myocardial fat on CT images has long been thought to be a bad thing, so researchers in New York City were surprised to find just the opposite in 1,000 patients: enhanced survival and potentially a readjusted risk profile.Left-ventricular (LV) myocardial fat has been described as a sign of chronic myocardial infarction (MI) and is frequently seen on noncontrast chest CT, Dr. Anna Bader, from Albert Einstein College of Medicine and Jacobi Medical Center in New York City, told AuntMinnie.com. Yet its clinical implications are poorly understood.
The study of 690 patients without MI and 265 patients with prior MI was designed to determine the relationship between myocardial fat and mortality.
"We postulated that LV fat in patients without prior MI indicates silent MI and portends higher mortality, approaching that of patients with a history of MI," Bader said.
But in patients with no MI, myocardial fat was associated with a 25% reduction in hazard of death. In the group with MI, myocardial fat was associated with a 31% adjusted reduction in hazard of death.
"Unexpectedly, patients with myocardial fat have improved survival, regardless of MI status, suggesting that myocardial fat is a beneficial biomarker," Bader said. "Myocardial fat on noncontrast chest CT, a widely used and readily available modality, may improve stratification beyond traditional risk factors."
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
