Epicardial Adipose Tissue as an Independent Cardiometabolic Risk Factor for Coronary Artery Disease

Nikoleta Karampetsou; Leonidas Alexopoulos; Aggeliki Minia; Vaia Pliaka; Nikos Tsolakos; Konstantinos Kontzoglou; Despoina N Perrea; Paulos Patapis

doi:10.7759/cureus.25578

Epicardial Adipose Tissue as an Independent Cardiometabolic Risk Factor for Coronary Artery Disease

Cureus. 2022 Jun 1;14(6):e25578. doi: 10.7759/cureus.25578. eCollection 2022 Jun.

Authors

Nikoleta Karampetsou¹, Leonidas Alexopoulos², Aggeliki Minia³, Vaia Pliaka³, Nikos Tsolakos³, Konstantinos Kontzoglou⁴, Despoina N Perrea¹, Paulos Patapis⁵

Affiliations

¹ Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, GRC.
² Mechanical Engineering, National Technical University of Athens, Athens, GRC.
³ Biotechnology, ProtATonce Ltd., Athens, GRC.
⁴ Propaedeutic Surgery, National and Kapodistrian University of Athens, Athens, GRC.
⁵ Surgery, National and Kapodistrian University of Athens, Athens, GRC.

Abstract

During the last decades, visceral adiposity has been at the forefront of scientific research because of its complex role in the pathogenesis of cardiovascular diseases. Epicardial adipose tissue (EAT) is the visceral lipid compartment between the myocardium and the visceral pericardium. Due to their unobstructed anatomic vicinity, epicardial fat and myocardium are nourished by the same microcirculation. It is widely known that EAT serves as an energy lipid source and thermoregulator for the human heart. In addition to this, epicardial fat exerts highly protective effects since it releases a great variety of anti-inflammatory molecules to the adjacent cardiac muscle. Taking into account the unique properties of human EAT, it is undoubtedly a key factor in cardiac physiology since it facilitates complex heart functions. Under pathological circumstances, however, epicardial fat promotes coronary atherosclerosis in a variety of ways. Therefore, the accurate estimation of epicardial fat thickness and volume could be utilized as an early detecting method and future medication target for coronary artery disease (CAD) elimination. Throughout the years, several therapeutic approaches for dysfunctional human EAT have been proposed. A balanced healthy diet, aerobic and anaerobic physical activity, bariatric surgery, and pharmacological treatment with either traditional or novel antidiabetic and antilipidemic drugs are some of the established medical approaches. In the present article, we review the current knowledge regarding the anatomic and physiological characteristics of epicardial fat. In addition to this, we describe the pathogenic mechanisms which refer to the crosstalk between epicardial fat alteration and coronary arterial atherosclerosis development. Lastly, we present both lifestyle and pharmacological methods as possible treatment options for EAT dysfunction.

Keywords: cad: coronary artery disease; coronary artery atherosclerosis; epicardial adipose tissue; inflammation; visceral adiposity.

Publication types

Review