Role of epicardial adipose tissue in diabetic cardiomyopathy through the lens of cardiovascular magnetic resonance imaging – a narrative review

Accumulating evidence suggests that ectopic/visceral adiposity may play a key role in the pathogenesis of nonischaemic cardiovascular diseases associated with type 2 diabetes. Epicardial adipose tissue (EAT) is a complex visceral fat depot, covering 80% of the cardiac surface with anatomical and fun...

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Bibliographic Details
Published in:Therapeutic advances in endocrinology and metabolism 2024-01, Vol.15, p.20420188241229540-20420188241229540
Main Authors: Kotha, Sindhoora, Plein, Sven, Greenwood, John P., Levelt, Eylem
Format: Article
Language:English
Subjects:
Adipose tissue
Bioaccumulation
Body fat
Cardiomyopathy
Cardiovascular disease
Cardiovascular diseases
Clinical trials
Coronary artery disease
Diabetes
Diabetes mellitus (non-insulin dependent)
Functional magnetic resonance imaging
Magnetic resonance imaging
Medical imaging
Myocardium
Pathogenesis
Phenotypes
Review
Structure-function relationships
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Summary:Accumulating evidence suggests that ectopic/visceral adiposity may play a key role in the pathogenesis of nonischaemic cardiovascular diseases associated with type 2 diabetes. Epicardial adipose tissue (EAT) is a complex visceral fat depot, covering 80% of the cardiac surface with anatomical and functional contiguity to the myocardium and coronary arteries. EAT interacts with the biology of the underlying myocardium by secreting a wide range of adipokines. Magnetic resonance imaging (MRI) is the reference modality for structural and functional imaging of the heart. The technique is now also emerging as the reference imaging modality for EAT quantification. With this narrative review, we (a) surveyed contemporary clinical studies that utilized cardiovascular MRI to characterize EAT (studies published 2010–2023); (b) listed the clinical trials monitoring the response to treatment in EAT size as well as myocardial functional and structural parameters and (c) discussed the potential pathophysiological role of EAT in the development of diabetic cardiomyopathy. We concluded that increased EAT quantity and its inflammatory phenotype correlate with early signs of left ventricle dysfunction and may have a role in the pathogenesis of cardiac disease in diabetes with and without coronary artery disease.
ISSN:2042-0188
2042-0196
DOI:10.1177/20420188241229540