Epicardial fat and vascular risk

Abstract

Due to its anatomical and functional proximity to the coronary circulation, epicardial adipose tissue may represent an even more direct CVD risk marker than central adiposity. Lifestyle measures and certain drugs may affect its thickness, although there are limited data currently available. The clinical implications of epicardial fat in daily practice remain to be established in future studies.

Epicardial Fat in Nonalcoholic Fatty Liver Disease

“…It has brown fat characteristics and a role in thermoregulation, modulates coronary vasomotion, and provides a protective framework for cardiac autonomic nerves and ganglia. [10][11][12][13] No fibrous layer exists between EAT and the myocardium or the coronaries, making it possible for free fatty acids, derived from triglyceride breakdown, to directly diffuse into the myocardium or the coronaries and via a paracrine-vasocrine signaling induce atherosclerotic lesion formation in obese individuals. 14 In contrast, EAT could act as a buffer absorbing free fatty acids to prevent cardiac lipotoxicity.…”

“…10 The most interesting hypothesis is that EAT can function as an endocrine organ that contributes to the inflammatory burden. 7,[9][10][11][12][13] The expression of the anti-inflammatory adiponectin is lower in EAT. 26 Several small studies have reported correlations between EAT and metabolic risk factors.…”

“…[9][10][11] Vasocrine and paracrine signaling of cytokines and hormones secreted from EAT might be a potential mechanism linking insulin resistance to atherogenesis. [11][12][13][14][15] So far, the modulation of EAT in humans remains to be elucidated, and it is not yet known whether NAFLD is associated with larger EAT.…”

Epicardial Fat Thickness in Psoriasis Patients

“…Epicardial adipose tissue functions as an active endocrine organ that produces several cytokines involved in oxidative stress, atherosclerosis, inflammation and angiogenesis [2]. Various studies have highlighted the potential importance of adipose tissue in relation to inflammatory burden in cardiovascular diseases.…”

Epipericardial Fat Necrosis as a Cause of Acute Chest Pain

“…CT remains the modality of choice for diagnosing the necrotic changes in the epipericardial and pericardial fat tissue ( 3,4 ). Magnetic resonance imaging may be utilized for diagnosis ( 5 ), but is typically unnecessary. Features of epipericardial fat necrosis include a self-limiting course and typical resolution of fi ndings on repeat imaging ( 6,7 ).…”