Department of Clinical Physiology, Centre of Postgraduate Medical Education, Warsaw, Poland.
Student's Cardiovascular Scientific Club "Kardioplegia", Medical University of Warsaw, Warsaw, Poland.
Cardiovasc Diabetol. 2024 Oct 29;23(1):389. doi: 10.1186/s12933-024-02474-x.
Epicardial adipose tissue (EAT) is a unique fat depot located between the myocardium and the visceral layer of pericardium. It can be further subdivided into pericoronary (PCAT), periatrial (PAAT) and periventricular adipose tissue (PVentAT), each of them exhibiting specific characteristics and association with the underlying tissue. Since no physical barrier separates EAT from the myocardium, this fat tissue can easily interact with the underlying cardiac structure. EAT can be visualized using various imaging modalities. Computed tomography provides not only information on EAT volume, but also on its density. Indeed, EAT density reflected by the recently developed fat attenuation index (FAI) is emerging as a useful index of PCAT inflammation, PAAT inflammation and fibrosis, while the relevance of density of PVentAT is much less known. The emerging data indicates that FAI can be an important diagnostic and prognostic tool in both coronary artery disease and atrial fibrillation. Future studies will demonstrate if it also could be used as a marker of efficacy of therapies and whether FAI PVentAT could indicate ventricular pathologies, such as heart failure. The aim of the review is to present computed tomography derived FAI as an important tool both to study and better understand the epicardial fat and as a potential predictive marker in cardiovascular disorders.
心外膜脂肪组织（EAT）是一种独特的脂肪组织，位于心肌和心包脏层之间。它可以进一步细分为冠状动脉周围脂肪组织（PCAT）、心房周围脂肪组织（PAAT）和心室内膜下脂肪组织（PVentAT），它们各自具有特定的特征，并与下方的组织相关联。由于没有物理屏障将 EAT 与心肌隔开，因此这种脂肪组织很容易与下方的心脏结构相互作用。可以使用各种成像方式来可视化 EAT。计算机断层扫描不仅提供了关于 EAT 体积的信息，还提供了其密度的信息。实际上，最近开发的脂肪衰减指数（FAI）所反映的 EAT 密度正在成为 PCAT 炎症、PAAT 炎症和纤维化的有用指标，而 PVentAT 密度的相关性则知之甚少。新兴的数据表明，FAI 可以成为冠心病和心房颤动的重要诊断和预后工具。未来的研究将证明它是否也可以用作治疗效果的标志物，以及 FAI PVentAT 是否可以指示心室病变，如心力衰竭。本综述的目的是将计算机断层扫描衍生的 FAI 作为研究和更好地理解心外膜脂肪的重要工具，并作为心血管疾病的潜在预测标志物。
