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Studies of rats, those ever-useful creatures, have already shown that a fatty heart accompanies obesity and type 2 diabetes. Furthermore, the heart fat produces toxins that cause heart cell death and then heart failure.
Scientists have also found fat in the "explanted" hearts of type 2s undergoing heart transplant. But they could never get a good look at the fat in the beating hearts of living people because their hearts (thankfully) wouldn't stand still for the picture. So they couldn't tell which came first, the fat or the diabetes and heart failure.
Recently, however, Texan scientists discovered a way to take an MRI of a beating heart and then use a computer program to freeze the image. With that technique, they examined the hearts of lean people, obese people with normal blood sugar, obese people with impaired glucose metabolism, and people with type 2 diabetes. And they found that the people with impaired glucose tolerance or type 2 diabetes had about twice as much "cardiac steatosis," or heart fat, as the lean people.
The amount of heart fat did not correlate with the amount of fat in the liver or bloodstream, but was related to the amount of stomach fat.
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Sources: EurekAlert; Circulation, September 2007