Abstract
Regional fat distribution appears to play a significant role in cardiovascular risk. Epicardial adipose tissue (EAT) is a type of visceral fat that is located adjacent to the heart in the thoracic cavity. Cytokines generated in EAT are postulated to diffuse directly to the vascular intima from the perivascular fat, leading to the initiation of inflammation, atherosclerosis development and plaque instability. Current research links increased EAT to an elevated risk of coronary artery disease. EAT has been correlated with both coronary artery calcification and angiographic coronary disease in most, but not all, studies. Further work is needed before EAT is included among the current battery of tests that are available for coronary artery disease risk stratification.