Epicardial Adipose Tissue in Cardiovascular Disease

Abstract

Cardiovascular disease (CVD) is the maincause of morbidity and mortality in industrialized countries, despite the evolution of treatments and revascularization strategies.Obesity, also accompanied by a chronicinflammatory process, is an independent riskfactor for CVD. Abdominal adipose tissue is acomplex, metabolically very active organcapable of producing different adipokines andhormones, responsible for endocrinemetabolic comorbidities. The epicardial adipose tissue (EAT) has not been as extensivelystudied as the abdominal or subcutaneous adipose tissue. However, recent evidence associates it with an increased cardiometabolic riskdue to its apposition with the heart. EAT storestriglycerides to provide energy to the myocardium and is characterized by its greater ability to release and capture free fatty acids. EATstrategic localization allows a singular crosstalk with cardiomyocytes and vascular wallcells. The fact that EAT produces proinflammatory adipokines as well as metalloproteinases and pro-oxidant substances,highlights its possible direct impact on plaquevulnerability and heart failure, being still necessary further studies of EAT behavior inCVD.