Physical exercise and epicardial adipose tissue: A systematic review and meta‐analysis of randomized controlled trials

Abstract

Summary We performed a meta‐analysis of the effects of exercise on epicardial adipose tissue (EAT). A systematic search was conducted in PubMed and Scopus (since inception to 1 February 2020) of randomized controlled trials assessing the effects of exercise interventions alone (with no concomitant weight loss intervention) on EAT. The standardized mean difference (Hedges' g) and 95% confidence interval between interventions were computed using a random effects model. Ten studies (including 521 participants who had, on average, overweight/obesity) met all inclusion criteria. Interventions were supervised and lasted 2 to 16 weeks (≥3 sessions·per week). Exercise significantly reduced EAT (g = 0.82 [0.57–1.07]) irrespective of the duration of the intervention or the EAT imaging assessment method. Exercise benefits were separately confirmed for endurance (six studies, n = 287; g = 0.83 [0.52–1.15]) but not for resistance exercise training (due to insufficient data for quantitative synthesis). It was not possible to compare the effect of high‐intensity interval training (HIIT) versus moderate‐intensity continuous training (two studies, one reporting higher benefits with HIIT and the other no differences). Physical exercise interventions—particularly endurance training, with further evidence needed for other exercise modalities—appear as an effective strategy for reducing EAT in individuals with overweight/obesity, which supports their implementation for cardiovascular risk reduction.

Association Between Epicardial Adipose Tissue and Stroke

“…The association between different types of pathogenic strokes and the thickness of epicardial fat may be related to the presence of atrial heart disease, which is currently considered one of the possible hidden causes of this type of stroke. In this view, multiple factors (such as inflammation, thickness of epicardial fat, changes in the autonomic nervous system) may be linked to atrial changes that favor the cardioembolic mechanisms in these strokes (41)(42)(43)(44)(45).…”

The effect and safety of high-intensity interval training in the treatment of adolescent obesity: a meta-analysis

“…This results in different combinations of exercise time and intermittent time to stimulate the body differently, resulting in different fatreducing effects produced by the body. Waist circumference is a simple evaluation index for evaluating visceral fat, and waist circumference reduction is of great significance for reducing the risk of cardiovascular disease (29). The highintensity short-interval HIIT program can withstand exercise intensity above 100% MAS (30).…”

Cardiac adiposity as a modulator of cardiovascular disease in HIV

“…Once EAT/PAT was recognized as a novel cardiac risk factor, several treatment strategies targeted this tissue with lifestyle and pharmaceutical interventions in the general population. Significant reductions of EAT/PAT volumes have been achieved following reduced‐calorie diets, bariatric surgery and sustained exercise programmes, even in the absence of weight loss [55,56]. Furthermore, lipid‐ and glucose‐lowering therapies, including statins, glucagon‐like peptide‐1 (GLP‐1) analogues, dipeptidyl peptidase‐4 (DPP‐4) inhibitors and sodium‐glucose co‐transporter inhibitors (SGLT2i), can reduce EAT in obese patients with or without diabetes, though it is not yet clear whether this reduction is clinically relevant [56‐60].…”