Volume 18 Supplement 1

19th Annual SCMR Scientific Sessions

Open Access

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

  • Rami Homsi1,
  • Alois Martin Sprinkart1, 2,
  • Juergen Gieseke1, 3,
  • Seyrani Yuecel4,
  • Darius Dabir1,
  • Julian A Luetkens1,
  • Christian Marx1,
  • Daniel Kuetting1,
  • Hans H Schild1 and
  • Daniel K Thomas1
Journal of Cardiovascular Magnetic Resonance201618(Suppl 1):O4

DOI: 10.1186/1532-429X-18-S1-O4

Published: 27 January 2016


Increased epicardial adipose tissue is associated with cardiovascular risk and disease, such as hypertension. Hypertensive patients are at greater risk for the development of myocardial infarction. Following validation of an ECG- and respiratory triggered 3D-Dixon pulse sequence we investigated for the first time epi- and pericardial fat volumes (EFV, PFV) in hypertensive men with and without myocardial infarction (MI).


55 hypertensive men (mean age 63.02 ± 10.73 years [y]) with and without coronary artery disease (CAD) and ten healthy controls were (mean age 59.00 ± 8.41 y) underwent a comprehensive cardiomagentic resonance (CMR) examination on a 1.5 Tesla MR system (Ingenia, Philips). EFV was assessed using a 3D transversal ECG- and respiratory navigator gated mDixon-sequence (3D-Dixon). Fat only images were reconstructed online at the scanner, and the segmentation of fat volumes was performed based on fat fraction maps (figure 1) using in-house software written in MATLAB (The MathWorks, Inc., Natick, MA). EFV and PFV were normalized to the body surface area.
Figure 1

(A-D) show the Dixon image analysis of epi-and pericardial fat in a 61 year old hypertensive male patient with known 1-vessel disease of the left anterior descendent artery, but without myocardial infarction: (A) reconstructed water only image. (B) and (C) reconstructed fat only image with the pericardial outlines. (D) computed fat-fraction map based on fat- and water-only images (with the transferred regions of interest). (E and F) show fat only images of a 67 year old health man (E) and of a 64 year old hypertensive man with known 3-vessel disease and myocardial infarction (F) with the arrows pointing at the pericardial outlines.


The healthy control group had significantly lower EFV and PFV than hypertensive men (52.98 ± 19.81 and 115.50 ± 53.57 versus 81.8 ± 33.90 and 194.86 ± 83.51; P < 0.05). EFV and PFV were also lower compared to patients with only hypertension and no CAD (n = 18; EFV 74.53 ± 26.40; PFV 174.60 ± 65.70; P < 0.05). Hypertensive men with MI (22 men, mean age 61.55 ± 10.50 y; EFV 94.14 ± 43.16, PFV 224.26 ± 100.79) had significantly higher fat volumes than hypertensive men without MI (33 men, mean age 63.17 ± 10.93 y; EFV 73.57 ± 23.27, PFV 175.26 ± 63.07; [P < 0.05, each]). At the same time there was no relationship with the presence or severity of CAD in patients without MI (n = 15; mean age 69.47 ± 10.70 y). There were no significant differences in age, BMI or heart rate between the groups.


3D-Dixon measurements revealed significantly higher epicardial fat volumes in hypertensive men with myocardial infarction compared to hypertensive men without myocardial infarction. This finding underscores the role of fatty tissue as an endocrine and metabolically active organ. Noninvasive CMR-based whole volume measurement of epicardial fat may play a relevant future role in cardiovascular risk stratification and disease management.

Authors’ Affiliations

Radiology, University Hospital Bonn
Institute of Medical Engineering, Ruhr-University
Philips Healthcare
Cardiology, Gemeinschaftskrankenhaus Bonn


© Homsi et al. 2016

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.