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For example, visceral AT is a pro-atherogenic secretory AT depot, while subcutaneous AT represents a more classical energy storage depot. Perivascular adipose tissue (PVAT) regulates vascular biology via paracrine cross-talk signals. In this position paper, the state-of-the-art knowledge of various AT depots is reviewed providing a consensus definition of PVAT around the coronary arteries, as the AT surrounding the artery up to a distance from its outer wall equal to the luminal diameter of the artery. Special focus is given to the interactions between PVAT and the vascular wall that render PVAT a potential therapeutic target in cardiovascular diseases. This Clinical Consensus Statement also discusses the role of PVAT as a clinically relevant source of diagnostic and prognostic biomarkers of vascular function, which may guide precision medicine in atherosclerosis, hypertension, heart failure, and other cardiovascular diseases. In this article, its role as a \u2018biosensor\u2019 of vascular inflammation is highlighted with description of recent imaging technologies that visualize PVAT in clinical practice, allowing non-invasive quantification of coronary inflammation and the related residual cardiovascular inflammatory risk, guiding deployment of therapeutic interventions. Finally, the current and future clinical applicability of artificial intelligence and machine learning technologies is reviewed that integrate PVAT information into prognostic models to provide clinically meaningful information in primary and secondary prevention.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad484","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T20:01:29Z","timestamp":1689796889000},"page":"3827-3844","source":"Crossref","is-referenced-by-count":240,"title":["Perivascular adipose tissue as a source of therapeutic targets and clinical biomarkers"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6983-5423","authenticated-orcid":false,"given":"Charalambos","family":"Antoniades","sequence":"first","affiliation":[{"name":"Acute Multidisciplinary Imaging and Interventional Centre, RDM Division of Cardiovascular Medicine, University of Oxford , Headley Way, Headington, Oxford OX39DU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7492-4984","authenticated-orcid":false,"given":"Dimitris","family":"Tousoulis","sequence":"additional","affiliation":[{"name":"1st Cardiology Department, National and Kapodistrian University of Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4479-6691","authenticated-orcid":false,"given":"Marija","family":"Vavlukis","sequence":"additional","affiliation":[{"name":"Medical Faculty, University Clinic for Cardiology, University Ss\u2019 Cyril and Methodius in Skopje , Skopje, North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1881-3635","authenticated-orcid":false,"given":"Ingrid","family":"Fleming","sequence":"additional","affiliation":[{"name":"Institute for Vascular Signalling, Centre of Molecular Medicine, Goethe University , Frankfurt ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J","family":"Duncker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thorax Center, Erasmus University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etto","family":"Eringa","sequence":"additional","affiliation":[{"name":"Cardiovascular-Program ICCC, Research Institute\u2014Hospital Santa Creu i Sant Pau, IIB-Sant Pau , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5652-2401","authenticated-orcid":false,"given":"Olivia","family":"Manfrini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9137-0143","authenticated-orcid":false,"given":"Alexios S","family":"Antonopoulos","sequence":"additional","affiliation":[{"name":"Acute Multidisciplinary Imaging and Interventional Centre, RDM Division of Cardiovascular Medicine, University of Oxford , Headley Way, Headington, Oxford OX39DU ,","place":["UK"]},{"name":"1st Cardiology Department, National and Kapodistrian University of Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"1st Cardiology Department, National and Kapodistrian University of Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Padr\u00f3","sequence":"additional","affiliation":[{"name":"Cardiovascular Program-ICCC, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica Sant Pau (IIB SANT PAU), Barcelona, Spain"},{"name":"CiberCV, Institute Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danijela","family":"Trifunovic-Zamaklar","sequence":"additional","affiliation":[{"name":"MedicalClinical, Cardiology Clinic, University Clinical Center, University of Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6031-2899","authenticated-orcid":false,"given":"Giuseppe","family":"De Luca","sequence":"additional","affiliation":[{"name":"Division of Cardiology, AOU Policlinico G. Martino, Department of Clinical and Experimental Medicine, University of Messina , Messina ,","place":["Italy"]},{"name":"Cardiologia Ospedaliera, Nuovo Galeazzi-Sant\u2019Ambrogio , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Guzik","sequence":"additional","affiliation":[{"name":"Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh ,","place":["UK"]},{"name":"Department of Medicine, Jagiellonian University, Collegium Medicum , Krakow ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edina","family":"Cenko","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Djordjevic-Dikic","sequence":"additional","affiliation":[{"name":"Medical Faculty, Cardiology Clinic, University Clinical Center, 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