Ectopic visceral fat: a clinical and molecular perspective on the cardiometabolic risk

Area of Science:

• Cardiovascular Medicine
• Metabolic Disorders
• Medical Imaging

Background:

• Cardiovascular diseases (CVDs) remain a primary cause of global mortality.
• Despite reduced smoking rates and focus on classical risk factors, a significant residual risk for CVDs persists.
• Ectopic visceral fat accumulation is recognized as a key contributor to metabolic dysfunction and cardiovascular disorders.

Purpose of the Study:

• To review the molecular mechanisms connecting ectopic fat accumulation to the development of various CVDs.
• To explore the translational relevance of these molecular processes in clinical observations.
• To highlight emerging evidence on ectopic fat's role in conditions beyond coronary artery disease.

Main Methods:

• Comprehensive literature review of imaging studies and molecular research.
• Analysis of data spanning over two decades.
• Translational approach linking pathobiology to clinical observations.

Main Results:

• Ectopic visceral fat is strongly associated with metabolic dysfunctions contributing to CVDs.
• Established link between visceral fat and coronary artery disease (CAD).
• Emerging evidence implicates ectopic fat in calcific aortic valve disease (CAVD), atrial fibrillation, and left ventricular dysfunction.

Conclusions:

• Ectopic fat accumulation is a critical, yet often overlooked, factor in the pathogenesis of diverse cardiovascular diseases.
• Understanding the molecular pathways is essential for developing novel therapeutic strategies targeting residual cardiovascular risk.
• A translational approach integrating molecular insights with clinical data is vital for advancing cardiovascular medicine.