The Role of Quantitative Assessment of Visceral Adipose Tissue of the Heart as a Predictor for Cardiovascular Events

Objective of this article – to evaluate possibilities to visualize cardiac visceral adipose tissue by echocardiography, computed tomography (CT), and magnetic resonanse imaging (MRI) and to systematize data on its physiological and pathological roles. To achieve this goal, the authors analyzed relevant Russian and foreign sources of literature in the scientific libraries eLIBRARY and PubMed, by using the keywords: “pericardial fat”, “epicardial fat”, “visceral fat of the heart”, “epicardial adipose tissue”, “pericardial adipose tissue”, and “adipocytokine”. Actual data as of November 2018 were collected. The review presents up-to-date data on the physiological and pathophysiological roles of cytokines secreted by pericardial adipose tissue, as well as on correlations and possible theories of the relationship between the volumes of pericardial adipose tissue and the development of coronary heart disease, atrial fibrillation, and metabolic syndrome. According to echocardiography, epicardial adipose tissue thickness is a reliable predictor for the presence of high-risk atherosclerotic plaques in the coronary arteries. Adipose tissue volume can be measured with high accuracy using CT (manual, semi-automatic, and automatic methods). A number of studies prove that MRI can be used for assigned tasks. The current notion of the role of these adipose depots can potentially be used in assessing the risk of cardiovascular diseases. The literature review presented confirms that visceral adipose tissue of the heart has a direct effect on the myocardium and coronary arteries and can be quantified using echocardiography, CT and MRI.