The relationship between pericardial fat volume and coronary atherosclerosis, both assessed by dual-source computed tomography, was investigated in 264 patients. Patients with atherosclerotic lesions had a significantly greater pericardial fat volume than patients without atherosclerosis. Additional analyses revealed that elevated pericardial fat volumes were significantly associated with low adiponectin and HDL concentrations and elevated tumor necrosis factor-a and C-reactive protein levels. In a related editorial, Clément et al. recognized the value of the study by Greif et al., which adds to the interesting discussion of the causal role of excess fat around the heart in coronary atherosclerosis. The editorial also discussed the links between inflammation and excess fat, particularly in ectopic depots.
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