# Epicardial adipose tissue

Epicardial adipose tissue (EAT) is the visceral fat sitting right on your heart, between the heart muscle and its surrounding sac (the pericardium). It is unusual: it shares the heart's own blood supply, and no barrier separates it from the heart muscle. That closeness lets it signal directly to the heart. In metabolic disease, EAT leaks pro-inflammatory cytokines (IL-6, TNF-α, CCL2), scarring signals (TGF-β, matrix metalloproteinases), and free fatty acids straight into the nearby heart muscle and coronary arteries. That promotes heart-muscle fibrosis, conduction delays, and unstable plaque. EAT is measured by cardiac CT (voxels about −190 to −30 HU) or by echocardiography (thickness on the right-ventricle wall). CT shows stronger prognostic links than echo head-to-head. A 2023 meta-analysis of 29 studies (19,709 patients; Chong et al., Circ Cardiovasc Imaging) found odds ratios of 2.53 and 2.63 for cardiac death and heart attack. EAT volume grows with age, independent of weight gain. And its CT density (a sign of local inflammation) is a proposed complement to volume, though randomized trial evidence is still limited.

## Sources

- Chong B, Jayabaskaran J, et al.. (2023). Epicardial Adipose Tissue Assessed by Computed Tomography and Echocardiography Are Associated With Adverse Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Circulation: Cardiovascular Imaging. https://doi.org/10.1161/CIRCIMAGING.122.015159
- Ernault AC, Meijborg VMF, Coronel R. (2021). Modulation of Cardiac Arrhythmogenesis by Epicardial Adipose Tissue: JACC State-of-the-Art Review. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2021.08.037
- Chu CY, Lee WH, Hsu PC, et al.. (2016). Association of Increased Epicardial Adipose Tissue Thickness With Adverse Cardiovascular Outcomes in Patients With Atrial Fibrillation. Medicine (Baltimore). https://doi.org/10.1097/MD.0000000000002874

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_Canonical: https://longevity-switzerland.com/en/glossary/epicardial-adipose-tissue · Part of Longevity Cities · Updated 2026-06-22_