Epicardial adipose tissue: pathophysiology and role in the development of cardiovascular diseases

Visceral adipose tissue is an important predictor of cardiovascular diseases, which carry more risk than total fat accumulation. Epicardial fat, a special form of visceral fat deposited around the heart, is considered an important predictor of the risk of cardiovascular disease, taking into account the production and release of adipocytokines. Recently, the number of experimental and clinical data proving the physiological and metabolic significance of epicardial fat is increasing. The thickness and volume of epicardial adipose tissue (EAT) have a strong correlation with obesity, impaired fasting glucose, insulin resistance, metabolic syndrome and atherosclerosis. Moreover, it is now clear that the connection between EAT and the heart is regulated by complex two directional pathways, since not only adipokines regulate cardiac function, but the heart affects EAT via paracrine signaling. Further study of the molecular mechanisms regulating the interaction between the heart and EAT will improve our understanding of the role of the latter in cardiac physiology and the development of disease mechanisms.