Perivascular adipose tissue (PVAT) resides at the outermost boundary of
the vascular wall, surrounding most conduit blood vessels, except for the
cerebral vessels, in humans. A growing body of evidence suggests that
inflammation localized within PVAT may contribute to the pathogenesis of
cardiovascular disease (CVD). Patients with autoimmune rheumatic diseases
(ARDs), e.g., systemic lupus erythematosus (SLE), rheumatoid arthritis (RA),
psoriasis, etc., exhibit heightened systemic inflammation and are at increased
risk for CVD. Data from clinical studies in patients with ARDs support a linkage
between dysfunctional adipose tissue, and PVAT in particular, in disease
pathogenesis. Here, we review the data linking PVAT to the pathogenesis of CVD
in patients with ARDs, focusing on the role of novel PVAT imaging techniques in
defining disease risk and responses to biological therapies.