Chest
Clinical InvestigationsCARDIOLOGYLipomatous Hypertrophy of the Interatrial Septum: A Prospective Study of Incidence, Imaging Findings, and Clinical Symptoms
Section snippets
Materials and Methods
From August 2001 to September 2002, a total of 1,292 patients underwent a contrast-enhanced thoracic CT scan at our institution. All examinations were done on a multislice-CT (MSCT) scanner (SOMATOM Volume Zoom; Siemens; Erlangen, Germany) using a breathhold technique, and identical technical parameters (ie, caudocranial data acquisition, collimation of 4 × 1.0 mm or 4 × 2.5 mm, and slice thickness of 3 or 6 mm). Eighty milliliters contrast agent (Solutrast 300; Byk Gulden; Konstanz, Germany)
Results
In the 1,292 patients investigated, we found 28 (2.2%; 16 women and 12 men) with LHIS. Clinical findings in our patient population are shown in Table 1.
The mean age of affected patients was 70.2 years (range, 57 to 87 years). Twelve of 28 patients (42.9%) showed a BMI of > 30. In 13 of 21 patients (61.9%), ECG rhythm abnormalities were present, and 8 patients showed atrial arrhythmias (atrial fibrillation, 5 patients; atrial premature complexes, 2 patients; and atrial tachycardia, 1 patient).
CT
Discussion
LHIS, also called “massive fatty deposits”14 or “lipomatous hamartoma,”15 is a well-known but uncommon finding with the accumulation of adipose tissue in the interatrial septum. After the first postmortem description in 1964,16 about 200 cases have been reported. Histologic studies in affected patients typically show hyperplasia of mature multivacuolated fat cells. Fetal fat, hypertrophied myocytes, myocardial fibers, and fibrosis in various quantities may be found.214 Although many theories
References (33)
- et al.
Clinical, electrocardiographic and morphologic features of massive fatty deposits (“lipomatous hypertrophy”) in the atrial septum
J Am Coll Cardiol
(1993) - et al.
Diagnosis of lipomatous hypertrophy of the atrial septum by two-dimensional echocardiography
J Am Coll Cardiol
(1983) - et al.
Lipomatous hypertrophy of the atrial septum: diagnosis by combined two-dimensional echocardiography and computerized tomography
Am J Cardiol
(1984) - et al.
Lipomatous hypertrophy of the interatrial septum: diagnosis by magnetic resonance imaging
J Comput Tomogr
(1988) - et al.
Usefulness of transesophageal echocardiography in diagnosing lipomatous hypertrophy of the atrial septum with comparison to transthoracic echocardiography
Am J Cardiol
(1992) - et al.
Atrial arrhythmias and lipomatous hypertrophy of the cardiac interatrial septum
Am Heart J
(1971) Abnormal electrical activity in lipomatous hypertrophy of the interatrial septum
Am Heart J
(1974)- et al.
Surgical management of extensive lipomatous hypertrophy of the right atrium
Cardiovasc Surg
(2000) - et al.
Lipomatous hypertrophy of the atrial septum presenting as a right atrial mass
Am J Surg Pathol
(1996) - et al.
Lipomatous hypertrophy of the cardiac interatrial septum: an unusual complication in long-term home parenteral nutrition in adult patients
JPEN J Parenter Enteral Nutr
(1991)