Regional differences in perivascular adipose tissue impacting vascular homeostasis

• Non-uniform and separate PVAT depots are found in different organs and tissues.
• Heterogeneous PVATs exhibit regional differences in phenotype and paracrine effects.
• PVATs confer regional susceptibility to vascular complications.
• PVATs may represent a novel target for pharmacological intervention in cardiometabolic disorders.

Perivascular adipose tissue (PVAT) releases several important vasoactive factors with physiological and pathophysiological paracrine effects. A large body of evidence suggests regional phenotypic and functional differences among PVAT depots, depending on the specific vascular bed or different regions in the vascular bed where the PVAT is located. These non-uniform and separate PVATs exert various paracrine effects on vascular structure and function that largely impact disease states, such as endothelial dysfunction, atherosclerosis, or insulin resistance. This emerging view of PVAT function requires considering heterogeneous PVAT as a specialized organ that can differentially regulate vascular function depending on its anatomical location. In this context, the adipose–vascular axis may represent a novel target for pharmacological intervention in vasculopathy in cardiometabolic disorders.