Association Between Epicardial Adipose Tissue and Stroke

Abstract

Epicardial adipose tissue (EAT) is correlated with endothelial dysfunction, metabolic syndrome, increased mortality and recent studies showed a possible association with the increased risk of stroke. We performed a systematic review of studies evaluating the association between EAT and stroke. Eighty studies met the inclusion criteria and were consequently analyzed. The review had Five main findings. First, the increased epicardial fat thickness (EFT) may be associated with the stroke episode. Second, regardless of the imaging method (echocardiography, MRI, and CT) this association remains. Third, the association of metabolic syndrome and atrial fibrillation seems to increase the risk of stroke. Fourth, this systematic review was considered as low risk of bias. Despite being unable to establish a clear association between EAT and stroke, we have organized and assessed all the research papers on this topic, analyzing their limitations, suggesting improvements in future pieces of research and pointing out gaps in the literature. Furthermore, the mechanistic links between increased EAT and stroke incidence remains unclear, thus, further research is warranted.

Atrial Cardiomyopathy: An Emerging Cause of the Embolic Stroke of Undetermined Source

“…In addition, recent work has shown that left ventricular wall motion abnormalities and changes in left heart function are potential sources of emboli in ESUS patients ( 37 ). Several studies also identified that accumulation of epicardial adipose tissue (EAT) around the left atrium is associated with increased risks of stroke ( 38 ). Future studies on the relationship between EAT around left atrium and different types of strokes are needed.…”

Transient elastography and serum markers of liver fibrosis associate with epicardial adipose tissue and coronary artery calcium in NAFLD

“…Coronary artery calcium (CAC) 8 , 8 and epicardial adipose tissue (EAT) 10 , 10 are considered surrogate markers of coronary artery disease and have significantly improved the cardiovascular risk classification in asymptomatic individuals 8 – 11 . EAT is a novel clinical biomarker not only associated with accelerated progression of subclinical coronary atherosclerosis 10 , 10 , but also mediator of cardiac arrhythmias 12 , left ventricular diastolic dysfunction 13 , and stroke 14 . EAT has important physiological functions 15 , nonetheless, excessive EAT leads to a proinflammatory state with adverse effects on the myocardium.…”

Epicardial adipose tissue thickness assessed by CT is a marker of atrial fibrillation in stroke patients

“…11 A systematic review of 8 small studies has recently suggested an increased risk of stroke with increased epicardial adipose tissue, but there was marked heterogeneity in the study populations and methodologies. 12 Only one previous study has analyzed epicardial adipose tissue in ischemic stroke patients with and without AF. 13 It demonstrated that patients with AF-related stroke had increased epicardial adipose tissue when compared to patients with ischemic stroke without AF, but this study displayed important limitations, namely measurement of epicardial adipose tissue only on the free wall of the right ventricle using echocardiography, the inclusion of non-embolic stroke patients and absence of adjustment for important variables such as body mass index and NTproBNP.…”