Roles of Epicardial Adipose Tissue in the Pathogenesis of Coronary Atherosclerosis　― An Update on Recent Findings ―

Abstract

Adipose tissue serves not only as an energy store or a mechanical cushion, but also as an endocrine organ. Recent evidence revealed that perivascular adipose tissue is involved in vascular homeostasis and pathophysiology of adjacent arteries by producing various adipokines. Epicardial adipose tissue (EAT) is located between the surface of the heart and the visceral layer of the pericardium and surrounds the coronary arteries. Many clinical studies suggest that an increase in EAT volume is associated with coronary artery disease. It has been reported that exercise and some antidiabetic drugs can reduce EAT volume. In this review, we outline recent findings on the roles of EAT in the pathogenesis of coronary atherosclerosis.

Relationship between Epicardial and Coronary Adipose Tissue and the Expression of Adiponectin, Leptin, and Interleukin 6 in Patients with Coronary Artery Disease

“…Adipose tissue (AT) is universally regarded as an endocrine and paracrine organ that synthesizes biologically active molecules. Adipocytokines are involved in various processes, including inflammation, fibrosis, and atherogenesis [2][3][4]. It has been shown that local fat depots, such as epicardial (EAT) and perivascular AT (PVAT), are associated with increased cardiovascular events, independent of traditional risk factors [5].…”

Longitudinal pericardial adipose tissue changes in patients with breast cancer receiving anthracycline-based chemotherapy: a retrospective cohort study

“…Some recent studies have proposed that physical exercise can reduce PAT due to reductions in proinflammatory adipokines and improvements of inflammatory factors in the milieu of the coronary vessel wall (28)(29)(30). Other studies have reported that sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists can reduce PAT in patients with type 2 diabetes (31,32).…”

Dysregulated Epicardial Adipose Tissue as a Risk Factor and Potential Therapeutic Target of Heart Failure with Preserved Ejection Fraction in Diabetes

“…The adipose tissue surrounding the heart involves two types of depots, the pericardial adipose tissue (PAT) and the EAT, even if the nomenclature is confusing, as some researchers use the terms paracardial or intrathoracic or mediastinal for pericardial fat, and the term pericardial fat to indicate the combination of paracardial fat with EAT [ 23 ]. PAT rests on the external surface of the pericardial fibrous layer, consists of adipocytes originating from the primitive thoracic mesenchyme, and is vascularized by non-coronary arteries.…”