Physical Exercise Potentially Targets Epicardial Adipose Tissue to Reduce Cardiovascular Disease Risk in Patients with Metabolic Diseases: Oxidative Stress and Inflammation Emerge as Major Therapeutic Targets

Abstract

Excess epicardial adiposity, within a state of obesity and metabolic syndrome, is emerging as an important risk factor for the development of cardiovascular diseases (CVDs). Accordingly, increased epicardial fat thickness (EFT) implicates the exacerbation of pathological mechanisms involving oxidative stress and inflammation within the heart, which may accelerate the development of CVDs. This explains increased interest in targeting EFT reduction to attenuate the detrimental effects of oxidative stress and inflammation within the setting of metabolic syndrome. Here, we critically discuss clinical and preclinical evidence on the impact of physical exercise on EFT in correlation with reduced CVD risk within a setting of metabolic disease. This review also brings a unique perspective on the implications of oxidative stress and inflammation as major pathological consequences that link increased EFT to accelerated CVD risk in conditions of metabolic disease.

A Review on the Antidiabetic Properties of Moringa oleifera Extracts: Focusing on Oxidative Stress and Inflammation as Main Therapeutic Targets

“…Metformin and insulin, which are commonly used antidiabetic therapies, have certainly prolonged the lives of patients with diabetes ( Joya-Galeana et al, 2011 ; Foretz et al, 2014 ; Bailey, 2017 ). Correspondingly, other effective interventions like physical exercise and caloric striction can be used to manage diabetes ( Nyawo et al, 2021 ; Shakoor et al, 2021 ; Mthembu et al, 2022 ), however only a few individuals can constantly adhere to such strenuous interventions. Besides lowering glucose or improving insulin sensitivity, it has become imperative to uncover therapies that can target the amelioration of both oxidative stress and inflammation, as the prime dysregulations implicated in the pathogenesis of diabetes ( Vikram et al, 2014 ; Mahlangu et al, 2020 ; Mokgalaboni et al, 2021b ).…”

The role of epicardial adipose tissue dysfunction in cardiovascular diseases: an overview of pathophysiology, evaluation, and management

“…A recent study showed that bad childhood experience is associated with increased EAT in children with depression and reduced physical exercise ( 116 ). Studies have indicated that regular physical activity is an effective non-invasive strategy for reducing EAT that may provide beneficial effects on the cardiovascular system ( 113 , 117 , 118 ). Several studies showed that aerobic exercise decreases EAT thickness significantly in obese men ( 118 , 119 ).…”

Epicardial adipose tissue, metabolic disorders, and cardiovascular diseases: recent advances classified by research methodologies

“…In the past decade, four types of interventions have been proposed to reduce EAT volume, including exercise interventions, dietary interventions, bariatric surgery, and pharmaceutical interventions 129–134 (Figure 3). There have been a number of well‐designed tables summarizing related clinical studies in recent systematic reviews 134–142 …”

“…Numerous studies have investigated the impact of exercise on EAT amount 135–137 . A variety of exercise training protocols were evaluated in these studies, including aerobic exercise, high‐intensity exercise, and resistance exercise, and the length of programs varies from 3 to 24 weeks 133,138,143–149 .…”