Earlier Prediction of Cardiovascular Risk with Epicardial Fat Assessment.

Area of Science:

• Cardiology
• Metabolic Research
• Adipose Tissue Biology

Background:

• Epicardial adipose tissue (EAT) is a distinct visceral fat depot with unique anatomical and metabolic characteristics.
• EAT shares microcirculation with the heart, suggesting potential interactions and influencing cardiac health.
• While normally protective, EAT can become detrimental in pathological conditions, impacting the myocardium and coronary arteries.

Purpose of the Study:

• To review the emerging evidence on epicardial adipose tissue's role in cardiac risk.
• To highlight EAT as an active player in cardiac pathology development.
• To discuss EAT as a potentially modifiable therapeutic target for cardiovascular diseases.

Main Methods:

• Review of scientific literature on epicardial adipose tissue.
• Analysis of EAT's anatomical, metabolic, and transcriptomic features.
• Correlation of EAT measurement with various cardiovascular and metabolic conditions.

Main Results:

• EAT exhibits properties similar to brown fat, offering metabolic and cardioprotective functions.
• Downregulation of EAT transcriptome occurs in advanced coronary artery disease.
• EAT thickness/volume measurement correlates with visceral adiposity, CAD, metabolic syndrome, and cardiac dysfunction.

Conclusions:

• Epicardial adipose tissue serves as a reliable marker for cardiovascular risk.
• EAT is an active participant in cardiac pathology and a potential therapeutic target.
• Interventions like improved vascularization, weight loss, and drugs can restore EAT's protective functions.