Research
Hormonal
Excess and dysfunctional epicardial adipose tissue (EAT) contributes to coronary microvascular dysfunction (CMD) and vasospastic angina (VSA) through pro-inflammatory signaling, oxidative stress, and smooth muscle hyperreactivity.
If you have chest pain with normal arteries (CMD or VSA), reducing epicardial fat through lifestyle or medication may improve symptoms by lowering inflammation and improving blood vessel function.
GoodSupportsHIGH confidence
Excess EAT secretes pro-inflammatory mediators that promote endothelial dysfunction in both epicardial and microvascular vessels, increase oxidative stress with reduced NO bioavailability, and enhance local inflammatory infiltration contributing to smooth muscle hyperreactivity.
Why this rating
Supported by multiple clinical studies and mechanistic reviews, though mostly observational or small trials.
Source
Epicardial adipose tissue in coronary microvascular disease
Veronika Gašpárková et al. · American Heart Journal Plus Cardiology Research and Practice · 2026
DOI 10.1016/j.ahjo.2026.100734
narrative_review
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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