Unlocking the Mysteries of Epicardial Adipose Tissue: Implications of Cardiometabolic Syndrome

Metabolic syndrome (MS) is a complex condition characterized by various factors, including abdominal obesity, high triglyceride levels, low high-density lipoprotein-cholesterol, high blood pressure, and elevated fasting blood sugar. Obesity, marked by the expansion of fat mass and increased fat cell production, is closely linked to MS. This review explores the role of adipose tissue (AT), particularly epicardial AT (EAT), in the development of MS and other cardiovascular complications. Notably, EAT, located around the heart and coronary arteries, is implicated in cardiovascular diseases such as coronary artery disease, atrial fibrillation, and heart failure through the production of proinflammatory cytokines. Emerging therapies, including glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors, have shown promise in reducing EAT thickness and improving cardiovascular outcomes. However, distinguishing visceral fat from subcutaneous fat in obese individuals remains a challenge, necessitating further research to develop targeted interventions. In conclusion, EAT plays a critical role in cardiovascular health, and ongoing studies are required to advance our understanding and develop precise interventions to mitigate its impact on cardiovascular diseases in at-risk individuals.