Epicardial Adipose Tissue: Clinical Biomarker of Cardio-Metabolic Risk

Abstract

Epicardial adipose tissue (EAT) is part of the visceral adipose tissue (VAT) that surrounds the heart and it is a quantifiable, modifiable, and multifaceted tissue that has both local and systemic effects. When EAT is enlarged, EAT contributes to atherosclerotic cardiovascular disease (ASCVD) risk and plays a role in the development of metabolic syndrome (MetS). In this review, we will discuss the role of EAT in various facets of MetS, including type 2 diabetes mellitus (T2DM) and insulin resistance. We examine the association between EAT and liver steatosis. We also address the correlations of EAT with HIV therapy and with psoriasis. We discuss racial differences in baseline EAT thickness. We conclude that EAT measurement serves as a powerful potential diagnostic tool in assessing cardiovascular and metabolic risk. Measurement of EAT is made less costly, more convenient, and yet accurate and reliable by transthoracic echocardiography. Furthermore, modification of EAT thickness has therapeutic implications for ASCVD, T2DM, and MetS.

Epicardial Adipose Tissue and IL-13 Response to Myocardial Injury Drives Left Ventricular Remodeling After ST Elevation Myocardial Infarction

“…Visceral and subcutaneous adipose tissues differ in accumulation and metabolism and the relationship between EAT and anthropometric parameters is still debated. Our and other groups previously reported that EAT increase is independent from BMI in patients with cardiovascular diseases (Parisi et al, 2015;Villasante Fricke and Iacobellis, 2019).…”

Adipokines and Inflammation: Focus on Cardiovascular Diseases

“…Moreover, it has been proposed that the adipokines released by EAT in pathological conditions have paracrine effects on cardiac electrical activity, affecting conductivity and promoting atrial fibrillation [ 20 ], and in coronary arteries, they cause atherosclerosis through the promotion of inflammation and immune cell infiltration [ 21 , 22 ]. Lately, EAT thickness has been considered a clinical biomarker that correlates to features of heart failure and metabolic syndrome [ 23 , 24 , 25 , 26 , 27 ]. Another fat depot that surrounds the coronary arteries is the perivascular adipose tissue (PVAT).…”

Osteopontin: The Molecular Bridge between Fat and Cardiac–Renal Disorders

“…This is due to the intimate connection between the myocardium and a peculiar VAT depot, known as epicardial fat [74][75][76], as there is no fascia muscle separating their anatomical layer walls [75]. In dysfunctional epicardial fat, the release of pro-inflammatory adipokines, including tumor necrosis factor (TNF)-α, interleukin (IL)-6, leptin and monocyte chemoattractant protein-1 (MCP-1) [77], contributes to worsening the atherogenic processes affecting the coronary arteries and myocardium [77]. Moreover, there is a growing interest in the characterization of the immune fat lineage in obese patients.…”