Epicardial adipose tissue in cardiovascular diseases: a potential therapeutic target

Figure 1. Potential role of epicardial adipose tissue in cardiovascular diseases. EAT is a unique fat depot located between the myocardium and the visceral pericardium. The EAT secretome may contribute to the pathogenesis of CVDs, such as CAD, AF, and HF, via paracrine mechanisms. Various imaging techniques are employed to evaluate EAT thickness or volume. Pharmacological agents such as sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide 1 receptor (GLP1R) agonists, and statins may target EAT, leading to cardioprotective effects.

Figure 2. Imaging techniques for the evaluation of EAT. The relative advantages (blue boxes) and limitations (red boxes) of several commonly used clinical imaging techniques are highlighted. (A) Epicardial fat is characterized as the echo-free space located between the myocardium and the visceral pericardium. Echocardiography image reproduced from “EAT in parasternal long axis view” by Fabián Islas, Eva Gutiérrez, Victoria Cachofeiro, Ernesto Martínez-Martínez, Gema Marín, Carmen Olmos, Irene Carrión, Sandra Gil, Patricia Mahía, Miguel Ángel Cobos, Alberto de Agustín and María Luaces 1, licensed under CC BY. Echocardiography is a commonly accessible and safe technique, though it is operator-dependent. (B) CT imaging has high accuracy and reproducibility, but it involves radiation exposure. Adapted from “A) Epicardial fat thickness (yellow arrows)” by Muhammed Bora Demircelik, Omer Caglar Yilmaz, Ozgul Malcok Gurel, Yusuf Selcoki, Inci Asli Atar, Alper Bozkurt, Kayihan Akin and Beyhan Eryonucu, licensed under CC BY-NC. (C) MRI can provide accurate volumetric quantification and avoid radiation exposure, but requires longer acquisition times and higher costs. Adapted from “Difference in EAT…