In Reply We appreciated the letter by Dr Iacobellis in response to our study¹ that assessed the clinical significance and genetic determinants of epicardial and pericardial adiposity in UK Biobank. Dr Iacobellis raised important points that are relevant for interpreting our findings.

First, we would note that there is considerable variation in terminology for adipose tissue surrounding the heart. Therefore, we adopted the recommendations of the 2023 European Society of Cardiology Working Group on Coronary Pathophysiology and Micro-circulation consensus statement.²

As Dr Iacobellis emphasizes, epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) are distinct adipose tissue compartments. PAT is located external to the pericardium, whereas EAT is in immediate proximity to the myocardium, surrounds the coronary arteries, and may have distinct physiologic functions.²