Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review

Konwerski, Michał; Opolski, Grzegorz; Grabowski, Marcin; Mazurek, Tomasz

doi:10.3390/biology11030355

Cited by 52 publications

(26 citation statements)

References 242 publications

(331 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Above and beyond, EAT could be considered a modifiable risk marker, and weight loss induced by diet, exercise, or drug treatment plays an important role in reducing EAT, and consequently cardiovascular risk [ 59 ]. Results of our meta-regression analysis indicate a strong association between EAT reduction and BMI in patients under cardiometabolic drug treatment, in particular, patients with higher BMI levels had more robust EAT reduction.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue: a systematic review and meta-analysis

Myasoedova

Parisi

Moschetta

et al. 2023

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Epicardial adipose tissue (EAT) plays an important role in cardiometabolic risk. EAT is a modifiable risk factor and could be a potential therapeutic target for drugs that already show cardiovascular benefits. The aim of this study is to evaluate the effect of cardiometabolic drugs on EAT reduction. Methods A detailed search related to the effect on EAT reduction due to cardiometabolic drugs, such as glucagon-like peptide-1 receptor agonist (GLP-1 RA), sodium-glucose cotransporter-2 inhibitors (SGLT2-i), and statins was conducted according to PRISMA guidelines. Eighteen studies enrolling 1064 patients were included in the qualitative and quantitative analyses. Results All three analyzed drug classes, in particular GLP-1 RA, show a significant effect on EAT reduction (GLP-1 RA standardize mean difference (SMD) = − 1.005; p < 0.001; SGLT2-i SMD = − 0.552; p < 0.001, and statin SMD = − 0.195; p < 0.001). The sensitivity analysis showed that cardiometabolic drugs strongly benefit EAT thickness reduction, measured by ultrasound (overall SMD of − 0.663; 95%CI − 0.79, − 0.52; p < 0.001). Meta-regression analysis revealed younger age and higher BMI as significant effect modifiers of the association between cardiometabolic drugs and EAT reduction for both composite effect and effect on EAT thickness, (age Z: 3.99; p < 0.001 and Z: 1.97; p = 0.001, respectively; BMI Z: − 4.40; p < 0.001 and Z: − 2.85; p = 0.004, respectively). Conclusions Cardiometabolic drugs show a significant beneficial effect on EAT reduction. GLP-1 RA was more effective than SGLT2-i, while statins had a rather mild effect. We believe that the most effective treatment with these drugs should target younger patients with high BMI. Graphical Abstract

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue: a systematic review and meta-analysis

Myasoedova

Parisi

Moschetta

et al. 2023

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…Its effectiveness has been demonstrated, among others, in postmenopausal women [ 82 ] and patients undergoing pulmonary venous isolation due to atrial fibrillation [ 83 ]. Other pharmacological possibilities, characterized by effects on endocardial fat tissue, concern the use of metformin, thiazolidinedione, SGLT2 inhibitors, GLP-1 agonists, DPP-4 inhibitors, canakinumab, methotrexate, colchicine [ 84 , 95 , 96 ]. Multidirectional treatment, as always, turns out to be the most effective, even in people with diagnosed comorbidities, e.g., diabetes.…”

Section: Discussionmentioning

confidence: 99%

The Importance of the Assessment of Epicardial Adipose Tissue in Scientific Research

Cheładze¹,

Martuszewski

Poręba

et al. 2022

JCM

View full text Add to dashboard Cite

Epicardial adipose tissue (EAT) exhibits morphological similarities with pericardial adipose tissue, however, it has different embryological origin and vascularization. EAT is a metabolically active organ and a major source of anti-inflammatory and proinflammatory adipokines, which have a significant impact on cardiac function and morphology. Moreover, it can regulate vascular tone by releasing various molecules. The relationship between EAT and cardiovascular disease and diseases of other organ systems is now considered a common discussion subject. The present clinical review article summarizes the epidemiological findings based on imaging techniques in studies conducted so far. In conclusion, evaluation of the epicardial adipose tissue constitutes a helpful scientific parameter, which can be assessed by means of different diagnostic imaging examinations.

show abstract

“…Technical issues remain concerning the absence of standardization of CAT measurement with CT despite an intrinsic superiority to echocardiography as it allows CAT volumetry CAT and the recent availability of semi-automated segmentation methods. In particular the value of CAT attenuation remains to be established as it has been shown to be highly heterogeneous [ 10 ] and potentially influenced by corticosteroid [ 26 ], statin or colchicine therapy [ 27 ]. Nevertheless, taken together, our data emphasize CATi index as one of the most important and specific predictors of outcome during COVID-19 infection in diabetic patients.…”

Section: Discussionmentioning

confidence: 99%

Cardiac adipose tissue volume assessed by computed tomography is a specific and independent predictor of early mortality and critical illness in COVID-19 in type 2-diabetic patients

Charpentier

Redheuil²,

Bourron³

et al. 2022

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Patients with type 2-diabetes mellitus (T2D), are characterized by visceral and ectopic adipose tissue expansion, leading to systemic chronic low-grade inflammation. As visceral adiposity is associated with severe COVID-19 irrespective of obesity, we aimed to evaluate and compare the predictive value for early intensive care or death of three fat depots (cardiac, visceral and subcutaneous) using computed tomography (CT) at admission for COVID-19 in consecutive patients with and without T2D. Methods Two hundred and two patients admitted for COVID-19 were retrospectively included between February and June 2020 and distributed in two groups: T2D or non-diabetic controls. Chest CT with cardiac (CATi), visceral (VATi) and subcutaneous adipose tissue (SATi) volume measurements were performed at admission. The primary endpoint was a composite outcome criteria including death or ICU admission at day 21 after admission. Threshold values of adipose tissue components predicting adverse outcome were determined. Results One hundred and eight controls [median age: 76(IQR:59–83), 61% male, median BMI: 24(22–27)] and ninety-four T2D patients [median age: 70(IQR:61–77), 70% male, median BMI: 27(24–31)], were enrolled in this study. At day 21 after admission, 42 patients (21%) had died from COVID-19, 48 (24%) required intensive care and 112 (55%) were admitted to a conventional care unit (CMU). In T2D, CATi was associated with early death or ICU independently from age, sex, BMI, dyslipidemia, CRP and coronary calcium (CAC). (p = 0.005). Concerning T2D patients, the cut-point for CATi was > 100 mL/m2 with a sensitivity of 0.83 and a specificity of 0.50 (AUC = 0.67, p = 0.004) and an OR of 4.71 for early ICU admission or mortality (p = 0.002) in the fully adjusted model. Other adipose tissues SATi or VATi were not significantly associated with early adverse outcomes. In control patients, age and male sex (OR = 1.03, p = 0.04) were the only predictors of ICU or death. Conclusions Cardiac adipose tissue volume measured in CT at admission was independently predictive of early intensive care or death in T2D patients with COVID-19 but not in non-diabetics. Such automated CT measurement could be used in routine in diabetic patients presenting with moderate to severe COVID-19 illness to optimize individual management and prevent critical evolution.

show abstract

Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review

Cited by 52 publications

References 242 publications

Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue: a systematic review and meta-analysis

Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue: a systematic review and meta-analysis

The Importance of the Assessment of Epicardial Adipose Tissue in Scientific Research

Cardiac adipose tissue volume assessed by computed tomography is a specific and independent predictor of early mortality and critical illness in COVID-19 in type 2-diabetic patients

Contact Info

Product

Resources

About