Adipose Tissue in and Around the Heart: Structural and Functional Insights From Cardiac Magnetic Resonance

A Andrea Barison (Fondazione Toscana Gabriele Monasterio, Pisa, Italy (A. Barison).) G Giovanni Donato Aquaro (Department of Surgical, Medical and Molecular Pathology and Critical Area, Academic Radiology Unit, University of Pisa, Italy (G.D.A.).) S Santo Dellegrottaglie (Advanced Cardiovascular Imaging Unit, Clinica Villa dei Fiori Acerra, Naples, Italy (S.D., A.S.).) S Stefania Rizzo A Antonio De Luca (Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Italy (A.D.L., G.S.).) V Viviana Maestrini (Department of Clinical, Anestesiological and Cardiovascular Science, Sapienza University, Rome, Italy (V.M.).) A Alessandra Scatteia (Advanced Cardiovascular Imaging Unit, Clinica Villa dei Fiori Acerra, Naples, Italy (S.D., A.S.).) A Andrea Baggiano M Monica de Gaspari P Pasquale Perrone Filardi (Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy (P.P.F.).) G Gianfranco Sinagra M Massimo Imazio (Cardiothoracic Department, University Hospital Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy (M.I.).) C Cristina Basso M Martina Perazzolo Marra (Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy (M.P.M).)

Abstract

Cardiac adipose tissue is normally present in the epicardium, but a variable amount can also be present in the myocardium, particularly in the subepicardial regions of the right ventricular anterolateral and apical regions. Pathological adipose tissue changes may occur in both ischemic (previous myocardial infarction) and nonischemic (previous myocarditis, arrhythmogenic cardiomyopathy, lipomatous hypertrophy of the interatrial septum, cardiac lipomas and liposarcomas) conditions, with or without extensive replacement-type myocardial fibrosis. Cardiac magnetic resonance is the gold standard imaging technique to characterize myocardial tissue changes and to distinguish between physiological and pathological cardiac fat deposits. In this review, we present the most common conditions presenting with myocardial fatty infiltration or with fatty replacement and the best magnetic resonance sequences to detect them, providing a comparison with histological findings and discussing their clinical significance.

Article Details

Journal Circulation
Volume / Issue Vol. 152, Issue 10
Published September 09, 2025
Pages 717-733
ISSN 0009-7322
Publisher Lippincott Williams & Wilkins

Journal Info

Circulation

Lippincott Williams & Wilkins

ISSN: 0009-7322 Health Sciences

Authors (14)

A

Andrea Barison

Fondazione Toscana Gabriele Monasterio, Pisa, Italy (A. Barison).

G

Giovanni Donato Aquaro

Department of Surgical, Medical and Molecular Pathology and Critical Area, Academic Radiology Unit, University of Pisa, Italy (G.D.A.).

S

Santo Dellegrottaglie

Advanced Cardiovascular Imaging Unit, Clinica Villa dei Fiori Acerra, Naples, Italy (S.D., A.S.).

S

Stefania Rizzo

A

Antonio De Luca

Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Italy (A.D.L., G.S.).

V

Viviana Maestrini

Department of Clinical, Anestesiological and Cardiovascular Science, Sapienza University, Rome, Italy (V.M.).

A

Alessandra Scatteia

Advanced Cardiovascular Imaging Unit, Clinica Villa dei Fiori Acerra, Naples, Italy (S.D., A.S.).

A

Andrea Baggiano

M

Monica de Gaspari

P

Pasquale Perrone Filardi

Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy (P.P.F.).

G

Gianfranco Sinagra

M

Massimo Imazio

Cardiothoracic Department, University Hospital Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy (M.I.).

C

Cristina Basso

M

Martina Perazzolo Marra

Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy (M.P.M).