title: Epicardial fat: definition, measurements and systematic review of main outcomes.
abstract: Epicardial fat (EF) is a visceral fat deposit, located between the heart and the pericardium, which shares many of the pathophysiological properties of other visceral fat deposits, It also potentially causes local inflammation and likely has direct effects on coronary atherosclerosis. Echocardiography, computed tomography and magnetic resonance imaging have been used to evaluate EF, but variations between methodologies limit the comparability between these modalities. We performed a systematic review of the literature finding associations of EF with metabolic syndrome and coronary artery disease. The summarization of these associations is limited by the heterogeneity of the methods used and the populations studied, where most of the subjects were at high cardiovascular disease risk. EF is also associated with other known factors, such as obesity, diabetes mellitus, age and hypertension, which makes the interpretation of its role as an independent risk marker intricate. Based on these data, we conclude that EF is a visceral fat deposit with potential implications in coronary artery disease. We describe the reference values of EF for the different imaging modalities, even though these have not yet been validated for clinical use. It is still necessary to better define normal reference values and the risk associated with EF to further evaluate its role in cardiovascular and metabolic risk assessment in relation to other criteria currently used.
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Angela Gallina
authors.initials: AG
authors.lastname: Bertaso
authors.forename: Daniela
authors.initials: D
authors.lastname: Bertol
authors.forename: Bruce Bartholow
authors.initials: BB
authors.lastname: Duncan
authors.forename: Murilo
authors.initials: M
authors.lastname: Foppa
mesh_terms: D003324:Coronary Artery Disease / Q000175:diagnosis; D004452:Echocardiography; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D024821:Metabolic Syndrome / Q000378:metabolism; D010496:Pericardium / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
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