TY - JOUR
T1 - Perivascular adipose tissue as a source of therapeutic targets and clinical biomarkers
AU - Antoniades, Charalambos
AU - Tousoulis, Dimitris
AU - Vavlukis, Marija
AU - Fleming, Ingrid
AU - Duncker, Dirk J.
AU - Eringa, Etto
AU - Manfrini, Olivia
AU - Antonopoulos, Alexios S.
AU - Oikonomou, Evangelos
AU - Padró, Teresa
AU - Trifunovic-Zamaklar, Danijela
AU - de Luca, Giuseppe
AU - Guzik, Tomasz
AU - Cenko, Edina
AU - Djordjevic-Dikic, Ana
AU - Crea, Filippo
N1 - Funding Information: C.A. declares funding from the British Heart Foundation (CH/F/21/90009 and RG/F/21/110040), and the British National Institute for Health and Care Research Oxford Biomedical Research Centre (BRC). D.J.D. was supported by the Dutch CardioVascular Alliance, an initiative with support of the Dutch Heart Foundation (Grant 2020B008 RECONNEXT) and is supported by the Netherlands CardioVascular Research Initiative: Dutch Heart Foundation, Dutch Federation of University Medical Centers, ZonMW, and Royal Netherlands Academy of Arts & Sciences (Grant CVON2017-ARENA PRIME). A.S.A. is supported by the Hellenic Foundation for Research and Innovation (Grant number 00468). Publisher Copyright: © 2023 Oxford University Press. All rights reserved.
PY - 2023/10/7
Y1 - 2023/10/7
N2 - Obesity is a modifiable cardiovascular risk factor, but adipose tissue (AT) depots in humans are anatomically, histologically, and functionally heterogeneous. For example, visceral AT is a pro-atherogenic secretory AT depot, while subcutaneous AT represents a more classical energy storage depot. Perivascular adipose tissue (PVAT) regulates vascular biology via paracrine cross-talk signals. In this position paper, the state-of-the-art knowledge of various AT depots is reviewed providing a consensus definition of PVAT around the coronary arteries, as the AT surrounding the artery up to a distance from its outer wall equal to the luminal diameter of the artery. Special focus is given to the interactions between PVAT and the vascular wall that render PVAT a potential therapeutic target in cardiovascular diseases. This Clinical Consensus Statement also discusses the role of PVAT as a clinically relevant source of diagnostic and prognostic biomarkers of vascular function, which may guide precision medicine in atherosclerosis, hypertension, heart failure, and other cardiovascular diseases. In this article, its role as a 'biosensor' of vascular inflammation is highlighted with description of recent imaging technologies that visualize PVAT in clinical practice, allowing non-invasive quantification of coronary inflammation and the related residual cardiovascular inflammatory risk, guiding deployment of therapeutic interventions. Finally, the current and future clinical applicability of artificial intelligence and machine learning technologies is reviewed that integrate PVAT information into prognostic models to provide clinically meaningful information in primary and secondary prevention.
AB - Obesity is a modifiable cardiovascular risk factor, but adipose tissue (AT) depots in humans are anatomically, histologically, and functionally heterogeneous. For example, visceral AT is a pro-atherogenic secretory AT depot, while subcutaneous AT represents a more classical energy storage depot. Perivascular adipose tissue (PVAT) regulates vascular biology via paracrine cross-talk signals. In this position paper, the state-of-the-art knowledge of various AT depots is reviewed providing a consensus definition of PVAT around the coronary arteries, as the AT surrounding the artery up to a distance from its outer wall equal to the luminal diameter of the artery. Special focus is given to the interactions between PVAT and the vascular wall that render PVAT a potential therapeutic target in cardiovascular diseases. This Clinical Consensus Statement also discusses the role of PVAT as a clinically relevant source of diagnostic and prognostic biomarkers of vascular function, which may guide precision medicine in atherosclerosis, hypertension, heart failure, and other cardiovascular diseases. In this article, its role as a 'biosensor' of vascular inflammation is highlighted with description of recent imaging technologies that visualize PVAT in clinical practice, allowing non-invasive quantification of coronary inflammation and the related residual cardiovascular inflammatory risk, guiding deployment of therapeutic interventions. Finally, the current and future clinical applicability of artificial intelligence and machine learning technologies is reviewed that integrate PVAT information into prognostic models to provide clinically meaningful information in primary and secondary prevention.
KW - Atherosclerosis
KW - Coronary computed tomography angiography
KW - Fat attenuation index
KW - Peri-vascular adipose tissue
UR - http://www.scopus.com/inward/record.url?scp=85173607027&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/eurheartj/ehad484
DO - https://doi.org/10.1093/eurheartj/ehad484
M3 - Review article
C2 - 37599464
SN - 0195-668X
VL - 44
SP - 3827
EP - 3844
JO - European Heart journal
JF - European Heart journal
IS - 38
ER -