The Role of Pericardial Fat in Cardiometabolic Disease: Emerging Evidence and Therapeutic Potential.

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2025-10-10 DOI:10.1007/s11886-025-02305-9

Zaid Shahrori, Michel Chedid El Helou, Sherin Sallam, Gianluca Iacobellis, Ian J Neeland

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Abstract

Purpose of review: This review explores the unique anatomy and pathophysiology of pericardial fat (including both epicardial adipose tissue [EAT] and paracardial fat), its clinical significance, and its potential role as a therapeutic target. It addresses key questions regarding the contribution of EAT to cardiometabolic conditions such as coronary artery disease, heart failure, atrial fibrillation, and ventricular arrhythmias, and explores interventions that reduce EAT to possibly improve cardiovascular outcomes.

Recent findings: Recent studies have established EAT as a metabolically active, pro-inflammatory fat depot directly affecting the myocardium and coronary arteries. Imaging and metabolomic studies have advanced the assessment of EAT burden. Clinical evidence supports lifestyle modification, pharmacologic therapies including GLP-1 RA and SGLT2i, and bariatric surgery to effectively reduce EAT volume. Emerging data link EAT reduction with improved cardiac function and arrhythmia risk, although causality remains unclear. EAT is a modifiable cardiometabolic risk factor associated with adverse outcomes in coronary artery disease, heart failure, atrial fibrillation, and ventricular arrhythmias. Targeting EAT through cardiometabolic risk reduction strategies may improve prognosis. Future research should focus on determining whether reducing EAT directly improves clinical outcomes.

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心包脂肪在心脏代谢疾病中的作用：新证据和治疗潜力。

综述目的：本文综述了心包脂肪（包括心外膜脂肪组织[EAT]和心包旁脂肪）独特的解剖和病理生理特征、临床意义及其作为治疗靶点的潜在作用。它解决了关于EAT对心脏代谢疾病（如冠状动脉疾病、心力衰竭、心房颤动和室性心律失常）的贡献的关键问题，并探讨了减少EAT以可能改善心血管结果的干预措施。最近的发现：最近的研究已经确定EAT是一种代谢活跃的、促炎的脂肪库，直接影响心肌和冠状动脉。影像学和代谢组学研究促进了对EAT负担的评估。临床证据支持改变生活方式，包括GLP-1 RA和SGLT2i在内的药物治疗，以及减肥手术，以有效减少进食量。新出现的数据链EAT降低与心功能改善和心律失常风险相关，尽管因果关系尚不清楚。EAT是一种可改变的心脏代谢危险因素，与冠状动脉疾病、心力衰竭、心房颤动和室性心律失常的不良结局相关。通过降低心脏代谢风险策略靶向EAT可能改善预后。未来的研究应侧重于确定减少进食是否能直接改善临床结果。

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来源期刊

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.