Epicardial Adipose Tissue: A Novel Potential Imaging Marker of Comorbidities Caused by Chronic Inflammation

Abstract

The observation of correlations between obesity and chronic metabolic and cardiovascular diseases has led to the emergence of strong interests in “adipocyte biology”, in particular in relation to a specific visceral adipose tissue that is the epicardial adipose tissue (EAT) and its pro-inflammatory role. In recent years, different imaging techniques frequently used in daily clinical practice have tried to obtain an EAT quantification. We provide a useful update on comorbidities related to chronic inflammation typical of cardiac adiposity, analyzing how the EAT assessment could impact and provide data on the patient prognosis. We assessed for eligibility 50 papers, with a total of 10,458 patients focusing the review on the evaluation of EAT in two main contexts: cardiovascular and metabolic diseases. Given its peculiar properties and rapid responsiveness, EAT could act as a marker to investigate the basal risk factor and follow-up conditions. In the future, EAT could represent a therapeutic target for new medications. The assessment of EAT should become part of clinical practice to help clinicians to identify patients at greater risk of developing cardiovascular and/or metabolic diseases and to provide information on their clinical and therapeutic outcomes.

Determinants of Arterial Stiffness in Patients with Morbid Obesity. The Role of Echocardiography and Carotid Ultrasound Imaging

“…Epicardial adipose tissue modulates the secretion of adipokines, molecules with an active role in the development of atherosclerosis [ 7 , 31 , 32 ]. In our study, we did not find statistically significant correlations between serum adipokine levels and epicardial adipose tissue thickness, but we attribute this result to the analysis of a small group of patients.…”

“…The integration of imaging diagnostic methods and the dosage of molecules with a predictive role on the risk of an acute cardiovascular event are useful tools in clinical practice and research alike, and the evidence of correlations between them opens new research directions [ 7 ]. The connection between arterial stiffness and obesity has been highlighted in multiple clinical studies in the literature.…”

Inflammatory plasma proteins predict short-term mortality in patients with an acute myocardial infarction

“…But there is also increasing evidence that the link between obesity and inflammation plays a major role in metabolic and cardiovascular diseases [ 51 – 53 ]. For instance, in a review paper Tarsitano et al discussed the specific relation between epicardial adipose tissue and its pro-inflammatory role in several cardiovascular diseases [ 54 ]. It has moreover been reported, that specific cardio-protective agents like Phosphodiesterase-5 inhibitors can positively affect the course of the diseases by modifying underlying inflammatory processes [ 55 , 56 ].…”

Relationship between epicardial adipose tissue measured by computed tomography and premature ventricular complexes originating from different sites

“…EAT is unevenly distributed around the heart, with a higher concentration in the atrioventricular and ventricular grooves. 9 In some previous studies, computed tomography (CT) has been used to visualize EAT and evaluate its distribution. 10 , 11 Previous studies only suggested that the volume of EAT around the right ventricle may have a higher correlation with the frequency of PVCs.…”