Focal macroscopic fat deposition within the right ventricular wall in asymptomatic patients undergoing screening EBCT coronary calcium scoring examinations

Purpose: Macroscopic focal fat deposition within the wall of the right ventricle (RV) has been historically associated with arrhythmogenic right ventricular dysplasia (ARVD). We attempt to characterize the incidence of macroscopic RV fat detected as an incidental imaging finding on electron beam computer tomography (EBCT). Methods: A total of 165 patients were imaged. Their electronic medical records and imaging studies were reviewed for age, gender, body-mass index, the presence of focal fat in the RV wall, and additional thoracic fatty proliferation. Results: A set of 28 patients (17%) had macroscopic fat along the RV wall. The mean age of the patients with fatty deposition was 58.6 ± 9.9, compared with 54.4 ± 9.9 for patients without it. The difference in incidence of the finding by mean age was statistically significant (P-value = 0.045). When grouped according to their Body Mass Index (BMI), there was no statistical association between the BMI category and the presence of focal fat deposition (P = 0.23). Conclusion: Macroscopic fatty deposition of the RV wall is a common incidental imaging finding in up to 17% of patients that increases in prevalence as age advances.