Epicardial adipose tissue (EAT) has unique properties due to its special anatomical structure, thermoregulation, and metabolic activity. Dysregulated EAT provokes the synthesis of pro-inflammatory cytokines, disorders in the metabolism of fats and glucose, as well as contributes to fatty degeneration of the myocardium and heart failure development. EAT may serve as a risk factor and biomarker for cardiovascular diseases, and is also a potential therapeutic target. The purpose of this review was to highlight current research data on EAT, secreted adipokines, their effect on target tissue metabolism, and to systematize the relationship between EAT and cardiovascular diseases. In particular, its function, role in heart failure, atrial fibrillation, as well as the prognostic value of various microRNAs determined in EAT are highlighted.

Visceral obesity is a key link in the metabolic syndrome and can affect the development of cardiovascular diseases. Objective. The aim of the study was to identify the clinical, laboratory and instrumental characteristics of patients with coronary artery disease, to analyze adverse cardiovascular events after coronary bypass surgery, according to the thickness of the epicardial adipose tissue (EAT). Design and methods. The study included 178 patients who underwent coronary bypass surgery. The median values of the thickness of the EAT was 0,4 cm. The patients were divided into 2 groups: group 1 — epicardial fat < 0,44 cm (n = 84) and group 2 — epicardial fat > 0,44 cm (n = 94). Results. The frequency of metabolic syndrome in group 1 was 59,5 %, while in group 2 — 74,5 % (p = 0,017). The thickness of the EAT correlated with blood glucose (r = 0,28, p = 0,003), body mass index (BMI) (r = 0,27, p = 0,010), waist circumference (r = 0,26, p = 0,001). End-diastolic volume of the left ventricle (p = 0,016), stroke volume (p = 0,014), thickness of the interventricular septum (p = 0,010), mass of the left ventricular myocardium (p = 0,048), left ventricular myocardial mass index (p = 0,035) were higher in the group with a higher content of EAT. The metabolic syndrome was a significant predictor of the EAT thickness. Conclusions. The EAT thickness is associated with the metabolic syndrome and its components.