Isomitdinov Bekzod, Mustaev Muslim, Khayatova Malikabonu, Jakaj Gentjan, Whiteford James, Oo Aung Ye
William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom.
Department of Adult Cardiac Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
J Cardiovasc Thorac Res. 2025 Jun 28;17(2):80-90. doi: 10.34172/jcvtr.025.33332. eCollection 2025 Jun.
Epicardial adipose tissue (EAT) is a fat layer of the heart located between the pericardium and myocardium and considered to be an important fat depot of the heart bearing thermoregulatory and protective functions, amongst others. Understanding of the dynamics of EAT, both positive and negative, opens new avenues for future cardiovascular research, including the development of new diagnostic and therapeutic tools. The aim of the study was to conduct a comprehensive literature review on the role of EAT, the factors influencing the change of its size, and to learn a causative relationship between fluctuations of EAT and different physiological and pathological conditions. Overall, 516 human studies indexed in PubMed, Embase, and Cochrane Library search engines (from inception up to January 2025) were screened. A total of 467 articles were excluded because they did not meet the inclusion criteria. Finally, 44 articles published from inception until January 2025 were reviewed. Our review categorises these factors into modifiable and non-modifiable, as well as aggravating and mitigating groups, to better understand their impact on EAT and cardiovascular health. Fluctuations of EAT may potentially represent a biomarker in cardiovascular research and medicine, however, it requires further validation in future studies. In such studies, it is advisable that the influencing factors are taken into consideration with adjusted normal reference ranges of EAT. Besides, the role of modifiable factors in coronary artery disease should be studied in future trials, which may shed light on the applicability of EAT as a biomarker and improve therapeutic modalities in heart disease.
心外膜脂肪组织（EAT）是位于心包和心肌之间的心脏脂肪层，被认为是心脏的一个重要脂肪库，具有多种功能，包括体温调节和保护功能等。了解EAT的动态变化，无论是正向还是负向，都为未来的心血管研究开辟了新途径，包括开发新的诊断和治疗工具。本研究的目的是对EAT的作用、影响其大小变化的因素进行全面的文献综述，并了解EAT波动与不同生理和病理状况之间的因果关系。总体而言，对PubMed、Embase和Cochrane图书馆搜索引擎（从创刊到2025年1月）收录的516项人体研究进行了筛选。共有467篇文章被排除，因为它们不符合纳入标准。最后，对从创刊到2025年1月发表的44篇文章进行了综述。我们的综述将这些因素分为可改变和不可改变的，以及加重和减轻的类别，以便更好地了解它们对EAT和心血管健康的影响。EAT的波动可能潜在地代表心血管研究和医学中的一种生物标志物，然而，这需要在未来的研究中进一步验证。在这类研究中，建议在考虑影响因素的同时调整EAT的正常参考范围。此外，未来的试验应研究可改变因素在冠状动脉疾病中的作用，这可能有助于阐明EAT作为生物标志物的适用性，并改善心脏病的治疗方式。
