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World J Cardiol. Apr 26, 2013; 5(4): 68-74
Published online Apr 26, 2013. doi: 10.4330/wjc.v5.i4.68
From the epicardial adipose tissue to vulnerable coronary plaques
Mauro Echavarría-Pinto, Lorenzo Hernando, Fernando Alfonso
Mauro Echavarría-Pinto, Fernando Alfonso, Interventional Cardiology, Cardiovascular Institute, Hospital Clinico San Carlos, 28040 Madrid, Spain
Lorenzo Hernando, Cardiology Department, Fundación Alcorcón, 28922 Madrid, Spain
Author contributions: All authors were involved in designing the research, performing the research, analyzing the data and writing the paper.
Correspondence to: Fernando Alfonso, MD, PhD, Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Plaza Cristo Rey, 28040 Madrid, Spain. falf@hotmail.com
Telephone: +34-91-3303283 Fax: +34-91-3303289
Received: February 13, 2013
Revised: March 21, 2013
Accepted: April 10, 2013
Published online: April 26, 2013
Processing time: 72 Days and 19.6 Hours
Abstract

Thin cap fibroatheromas (TCFAs) are thought to be the most common underlying substrate in patients suffering acute coronary thrombotic events. Recently, an interesting association between TCFAs and a particular depot of visceral fat called epicardial adipose tissue (EAT) has been suggested. In this article, we discuss some basic and clinical aspects of this association and then briefly review some of the pathophysiological characteristics attributed to EAT that explain why this particular depot of fat has been attracting the attention of the cardiological scientific community in recent years. Finally we discuss the value of optical coherence tomography in the diagnosis of TCFAs and the role of multislice computed tomography to assess EAT.

Keywords: Epicardial adipose tissue; Thin-cap fibroatheromas; Coronary thrombotic events; Optical coherence tomography; Multislice computed tomography

Core tip: Thin cap fibroatheromas (TCFAs) are the most common underlying substrate in patients suffering acute coronary thrombotic events. Recently, an interesting association between TCFAs and a particular depot of visceral fat called epicardial adipose tissue has been suggested. In this study, we review some basic and clinical aspects of behind this interesting association as well as the value of optical coherence tomography in the diagnosis of TCFAs.