Is the Measurement of Epicardial Fat in Obese Adolescents Valuable?

Epicardial adipose tissue is a visceral fat originated from splanchnophrenic mesothelial cells and has same origin with mesenteric and omental fat. It is located between the parietal and visceral pericardium. Although paracardial fat on external surface of the parietal pericardium is located very close to the epicardial fat, it’s origin-the primitive thoracic mesenchyme, is different from epicardial fat. Currently known functions of the epicardial adipose tissue include: 1) to buffer the coronary artery against the tension or torsion induced by the arterial pulse wave; 2) to easily expand the environment of the coronary arteries; 3) to act as a buffer taking up fatty acids to avoid levels that are toxic to the myocardium; 4) to act as a local energy source for cardiac muscle; 5) to facilitate coronary artery remodeling; 6) to act in the anatomic environment for the intrinsic cardiac nervous system as numerous ganglia and interconnecting nerves. The clinical significance of epicardial fat has not been studied extensively. However, the studies on the clinical utility of epicardial fat have gradually been increasing. Body mass index (BMI) was significantly correlated with the amount of epicardial fat and one review showed that elevation of body adiposity was related well with increase in epicardial adipose tissue. Metabolic syndrome, an agglomeration of inter-related metabolic risk factors, is strongly related to cardiovascular diseases. Several studies reported that metabolic syndrome is highly related to an elevation in the amount of Editorial