Epicardial and pericardial fat are distinguished as two functionally distinct cardiac depots, with deep-learning segmentation and standardization advancing their imaging quantification toward cardiovascular risk stratification
This review systematically examines the anatomy, physiology, and pathophysiological roles of epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT), compares CT, MRI, and echocardiography for quantifying these depots, notes that deep-learning segmentation (with Dice coefficients reported from 0.82 to 0.98) improves accuracy and reproducibility, and summarizes conflicting imaging evidence on EAT's link to cardiovascular outcomes alongside findings that statins, GLP-1 receptor agonists, SGLT2 inhibitors, and lifestyle interventions can reduce EAT volume.