Perivascular adipose tissue in cardiovascular disease: From mechanisms to therapeutic targets

Vascular inflammation plays a pivotal role in the development and progression of cardiovascular pathology. Understanding the mechanisms underlying vascular inflammation is therefore essential for the prevention and treatment of cardiovascular diseases. In recent years, perivascular adipose tissue (PVAT), which surrounds arteries ranging from the aorta to the coronary and peripheral arteries, has emerged as a key player in vascular pathophysiology. Notably, recent clinical trials have demonstrated that antidiabetic agents such as glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors exert cardiovascular benefits beyond glycemic control. Basic and translational studies suggest that these agents may modulate both the quantity and functional phenotype of coronary PVAT, further highlighting its relevance as a therapeutic target. In this review, we summarize the current understanding of the role of PVAT in vascular inflammation and remodeling and discuss its potential as a novel target for the prevention and treatment of cardiovascular diseases.