Epicardial adipose tissue and relationship with coronary artery disease

Abstract

<jats:title>Abstract</jats:title><jats:p>Epicardial adipose tissue (EAT) is metabolically active tissue that accumulates around the coronary arteries. Epicardial fat is a rich source of free fatty acids and may contribute to local inflammatory load by increased synthesis of inflammatory cytokines. Direct passage of bioactive molecules into the coronary arteries due to close contact with the vascular wall and the lack of fascia may contribute to the pathogenesis of coronary artery disease. Direct correlation between visceral fat and EAT defines the latter as an indirect marker of intra-abdominal visceral adiposity. EAT is related to anthropometric and clinical features of the metabolic syndrome (MS) and to hepatic transaminases as markers of steatohepatitis. An increase in EAT thickness is related to an increase in left ventricular mass and is correlated with atrial enlargement and impairment in diastolic filling in obesity. Echocardiographic study of EAT is an easy and reliable imaging indicator of visceral adiposity and cardiovascular risk. EAT is an independent factor strongly correlated with significant coronary stenosis. A level of EAT above an established average value can be considered a predictive marker of cardiovascular risk. We review the most recent studies proving the specific active role of EAT in the development of cardiac disease.</jats:p>

Correlation between Epicardial Fat Thickness and Clinical and Anthropometric Variables in an Elderly Population

“…heart diseases, especially coronary artery disease. [5][6][7][8][9][10][15][16][17][18][19][20][21][22][23] Although EF has been considered by some authors as an important predictive marker of cardiovascular and metabolic risk, 8,16 its association with other risk factors in elderly populations, makes its interpretation as an independent risk marker difficult. 8 The association of EF thickness with age and gender has been controversial in the published studies.…”

“…Regarding anthropometric parameters, EF thickness seems to correlate with weight, [25][26][27][28][29][30][31]33 height, 31 abdominal circumference, [10][11][12][13]19,22,25,28,29,[33][34] and fat mass, 11,12 and and regarding the correlation correlation between EF thickness and body mass index (BMI) the results have been contradictory. 2,[9][10][11][12]22,[25][26]28,29,31,[33][34] The association of EF thickness with obesity has been widely described, 11,[16][17]31,[35][36][37] and significant changes in EF thickness in severely obese individuals undergoing weight loss programs or interventions have been reported. 30,37,38 Although the relationship between EF thickness and some clinical conditions such as diabetes and dyslipidemia is not in the literature, its correlation with hypertension seems to be more evident.…”

“…[5][6][7][8][9][10][11][12][13] It can be deposited throughout the entire myocardium, but it is predominant in the atrioventricular and interventricular sulci, extending to the apex and around the coronary arteries. 6,[8][9][14][15][16] The EF shares its embryological origin with the intra-abdominal visceral fat, 10,14 and the microcirculation with the myocardium and coronary arteries. It can be a potential cause of local inflammation and has direct effects on coronary atherosclerosis through the release of anti-and pro-inflammatory substances, with correlations with the severity of metabolic syndrome and anthropometric and other echocardiographic variables in an old adult population.…”

Evaluation of cardiovascular remodeling and epicardial fat thickness in patients with chronic heart failure and metabolic syndrome

“…В обзорах, посвященных проблеме ожирения, ТЭЖ тесно коррелирует с толщиной висцерального жира, окружностью талии (ОТ) и является независимым фактором риска развития ССЗ [4].…”

Usefulness of Reynolds Risk Score in men with stable angina

“…New factors of pathogenesis of the coronary artery disease are still under investigations, such as epicardial adipose tissue (EAT), which is metabolically active tissue that accumulates around the coronary arteries and may contribute to local inflammatory load by increased synthesis of inflammatory cytokines [19]. In view of ongoing inflammatory processes in the wall of the coronary arteries, it seems that the risk scores, which take into account the hsCRP level as RRS, may be helpful in decision process for invasive diagnostic tests such as coronary angiography.…”