Epicardial adipose tissue in contemporary cardiology

Abstract

Interest in epicardial adipose tissue (EAT) is growing rapidly, and research in this area appeals to a broad, multidisciplinary audience. EAT is unique in its anatomy and unobstructed proximity to the heart and has a transcriptome and secretome very different from that of other fat depots. EAT has physiological and pathological properties that vary depending on its location. It can be highly protective for the adjacent myocardium through dynamic brown fat-like thermogenic function and harmful via paracrine or vasocrine secretion of pro-inflammatory and profibrotic cytokines. EAT is a modifiable risk factor that can be assessed with traditional and novel imaging techniques. Coronary and left atrial EAT are involved in the pathogenesis of coronary artery disease and atrial fibrillation, respectively, and it also contributes to the development and progression of heart failure. In addition, EAT might have a role in coronavirus disease 2019 (COVID-19)-related cardiac syndrome. EAT is a reliable potential therapeutic target for drugs with cardiovascular benefits such as glucagon-like peptide 1 receptor agonists and sodium–glucose co-transporter 2 inhibitors. This Review provides a comprehensive and up-to-date overview of the role of EAT in cardiovascular disease and highlights the translational nature of EAT research and its applications in contemporary cardiology.

The density of crown-like structures in epicardial adipose tissue could play a role in cardiovascular diseases

“…Epicardial adipose tissue (EAT) is a visceral fat with a peculiar anatomical contiguity with the myocardium. A positive correlation between EAT thickness and cardiac diseases has been shown [5,6].…”

Muscle and Adipose Tissue Communicate with Extracellular Vesicles

“…Ischemic heart disease and endomyocardial fibrosis are the primary causes of heart failure, and it is well established that perivascular and epicardiac AT participates in cardiac cell alteration during metabolic diseases through the release of proinflammatory cytokines [30]. In the context of atrial fibrillation, it has been found that epicardiac adipose tissue also exports EVs (epAT-EVs) with profibrotic and proarrhythmic properties [31].…”

Recent Progress in Epicardial and Pericardial Adipose Tissue Segmentation and Quantification Based on Deep Learning: A Systematic Review

“…In this paper, we review papers that segment whole EAT or PAT volumes from their surrounding tissues, and not papers that aim to segment different regions inside EAT or PAT, such as left atrial EAT vs. left ventricular EAT. While there is evidence that the distribution of EAT around the heart is important [5], segmenting the whole volume is a prerequisite for the analysis of its distribution and is, therefore, the focus of this review.…”