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Updated: Jul 26, 2025

An Intact Pericardium Ischemic Rodent Model
Published on: September 2, 2021
Pericardial fat and cardiovascular diseases: A systematic review and meta-analysis
Hanna K Al-Makhamreh1, Ahmad A Toubasi2, Layla M Al-Harasis3
1Cardiology Section, Faculty of Medicine, Department of Internal Medicine, University of Jordan, Amman, Jordan.
Insights
Pericardial fat is significantly linked to various cardiovascular diseases, including coronary artery disease and heart failure. Further research may incorporate pericardial fat into cardiovascular risk scores.
Area of Science:
- Cardiology
- Medical Imaging
- Obesity Research
Background:
- Pericardial fat accumulation is increasingly recognized as a risk factor for cardiovascular diseases.
- Previous studies have explored this association, but a comprehensive systematic review and meta-analysis was lacking.
Approach:
- A systematic literature search was conducted across major databases (PubMed, Cochrane Library, Scopus, Google Scholar, Clinicaltrials.gov).
- Observational studies investigating the relationship between pericardial fat and cardiovascular diseases were included.
- Data analysis was performed using Meta XL 5.3.
Key Points:
- The meta-analysis included 83 studies with 73,934 patients.
- Significant associations were found between pericardial fat and coronary artery disease (CAD), ventricular dysfunction, heart failure (HF), atrial fibrillation (AF), major adverse cardiac events (MACE), and coronary artery calcifications (CAC).
- Insufficient data precluded analysis of pericardial fat's relationship with other arrhythmias or cardiovascular risk scores.
Conclusions:
- Pericardial fat volume is significantly associated with multiple cardiovascular diseases.
- Given its link to obesity, pericardial fat warrants further investigation as a potential addition to existing cardiovascular risk assessment tools.
Objective:
Previous studies investigated the effect of pericardial fat on cardiovascular diseases. However, until now there was no systematic review and meta-analysis investigated this association, thus we conducted this article to assess the relationship between pericardial fat and cardiovascular diseases.
Methods:
We searched PubMed, The Cochrane Library, Scopus, Google Scholar and Clinicaltrials.gov to select observational studies reported the relationship between pericardial fat and cardiovascular diseases including coronary artery disease (CAD), ventricular dysfunction, heart failure (HF), atrial fibrillation (AF), major adverse cardiac events (MACE), coronary artery calcifications (CAC), arrhythmias other than atrial fibrillation, and cardiovascular events prediction scores. Meta XL 5.3 was used for data analysis.
Results:
A total of 83 articles that included 73,934 patients were included in our analysis. The results showed that pericardial fat was significantly associated with CAD (OR = 1.38; 95% CI: 1.28-1.50), ventricular dysfunction (OR = 1.53 per 1 mm3 ; 95% CI: 1.17-2.01), HF (OR = 1.32 per 1 mm3 ; 95% CI: 1.23-1.41), AF (OR = 1.16 per 1 mm3 ; 95% CI: 1.09-1.24), MACE (OR = 1.39 per 1 mm3 ; 95% CI: 1.22-1.57), and CAC (OR = 1.15 per 1 mm3 ; 95% CI: 1.05-1.27). On the other hand, there was no enough data about the relationship between pericardial fat with arrhythmias other than atrial fibrillation or cardiovascular risk scores.
Conclusion:
The analysis demonstrated that the relationship between pericardial fat volume and cardiovascular diseases was significant. Since pericardial fat is a good predictor of obesity, it suggests investigating its relationship and adds on effect to previously established risk factor to evaluate the possibility of incorporating it with cardiovascular risk scores.
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