Physiological and pathological significance of pericardial fat for the heart and adjacent vessels

Investigating the adipose tissue surrounding the heart and large vessels, the so-called pericardial fat, is of great interest for researchers. Pericardial fat is currently being considered a new cardiovascular risk factor, which forces us to reconsider the pathogenesis of various cardiovascular disorders. The article describes the concept of pericardial fat, including its heterogeneous structure and origin determining its functional role. In addition, the specific characteristics of pericardial fat in patients from various clinical groups are described. The main attention is paid to the significance of the metabolic activity of pericardial adipose tissue and its effect on nearby structures, such as the heart and coronary arteries. Based on modern scientific concepts, we have identified the main components of pathogenesis of coronary atherosclerosis, myocardial fibrosis and atrial fibrillation and the role of pericardial adipose tissue. The relationship between adipose tissue characteristics and risk factors for heart disease development remains questionable and requires further investigation. The article summarizes the importance of future studies of the parameters and properties of adipose tissue in individuals with identified cardiovascular pathology.