Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Arq Bras Cardiol. 2013 Jul;101(1):e18-28. doi: 10.5935/abc.20130138.
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.
心外膜脂肪（EF）是一种内脏脂肪沉积，位于心脏和心包之间，它与其他内脏脂肪沉积具有许多相同的病理生理特性。它还可能引起局部炎症，并可能对冠状动脉粥样硬化产生直接影响。超声心动图、计算机断层扫描和磁共振成像已被用于评估 EF，但方法之间的差异限制了这些方式之间的可比性。我们对文献进行了系统回顾，发现 EF 与代谢综合征和冠状动脉疾病有关。由于使用方法和研究人群的异质性，这些关联的总结受到限制，其中大多数研究对象具有较高的心血管疾病风险。EF 还与其他已知因素相关，如肥胖、糖尿病、年龄和高血压，这使得解释其作为独立风险标志物的作用变得复杂。基于这些数据，我们得出结论，EF 是一种内脏脂肪沉积，可能与冠状动脉疾病有关。我们描述了不同成像方式的 EF 参考值，尽管这些值尚未经过临床验证。仍有必要更好地定义正常参考值以及 EF 相关的风险，以进一步评估其在与目前使用的其他标准相关的心血管和代谢风险评估中的作用。
