Epicardial adipose tissue (EAT), referring to the visceral fat deposit between the outer wall of the myocardium and the visceral layer of the pericardium, was clinically measured by echocardiography, computed tomography volumetric quantification and magnetic resonance imaging(MRI). More and more evidence showed that EAT is a useful and significant imaging biomarker for predicting the risk of a variety of major adverse cardiovascular events (MACE), which was defined as cardiac death, myocardial infarction (MI), unstable angina, coronary revascularization, ischemic stroke, or heart failure. However, the observational studies used to date have limitations that restrict their ability to establish causality, such as unmeasured confounding.
This research project aims to investigate the causal relationship between increased EAT thickness or volume and higher risks of MACE. We will conduct a Mendelian Randomization study by using genetic variant or other mediator which is associated with both EAT thickness and MACE occurrence as an instrumental variable, while controlling for potential confounding factors in UK population..
This study is the first to use the UK Biobank to investigate the effects of EAT thickness or volume on the incidence rate of MACE, providing a novel and unconventional perspective and more comprehensive understanding on the pathophysiology of major cardiovascular diseases. Such program could help us understand if EAT is causally linked to MACE morbidity, which will inform the development of novel intervention strategies including screening for early detection and therapeutics to reduce the burden of cardiovascular disease in UK population. Our program proposes to be finished within 2-3 years.