Background & objectives: The normal heart includes epicardial adipose tissue (EAT) and myocardial fat – both increase with obesity. EAT is related to risk of heart disease and myocardial fat with arrhythmogenesis. The objectives is to estimate myocardial fat using stereological methods.

Methods: We included 115 deceased with a post-mortem computed-tomography of the eviscerated heart to establish EAT volume. We examined six samples (ant., lat., and post.) from the left (LV) and right ventricle (RV) of the midventricular slice. The percentage of myocardial fat was estimated stereological using Visiopharm software. Kidney and omental fat were weighed at autopsy and waist-hip-ratio calculated.

Results: The group consisted of more males (66/49; 57%), mean age at death was 53.4 years (range 21-93) and mean BMI was 25.4 (±5.6). Females had a slightly non-significant (p=0.054) larger proportion of RV fat (mean 12.1%, range 9.7-16.6) compared to men (10.8%, range 9.4-12.8). We found a positive correlation with BMI and LV fat (p=0.033). In the RV the correlation was only borderline significant (p=0.052). EAT volume was positively correlated with fat in the RV and LV. We found no association with waist-hip-ratio, omental or kidney fat as measures of visceral adipose tissue (VAT).

Conclusion: Myocardial fat is a normal component especially in the RV and correlates with the total volume of EAT. We surprisingly found no association with VAT.