Exploring the Complexity: Understanding the Role and Clinical Implications of Pericardial Adipose Tissue in Cardiovascular Diseases Pathophysiology
Abstract
Epicardial adipose tissue (EAT) is an important area of research related to cardiovascular disease. It plays a key role in cardiac and coronary vascular function by storing fatty acids and regulating coronary microcirculation. In this review, we discuss the function of EAT and its relationship to cardiovascular disease. The relationship between EAT and diseases such as coronary artery disease and heart failure is analysed, with a focus on pathophysiological mechanisms. In the following section, we present methods for imaging EAT and possible therapeutic strategies: lifestyle changes, bariatric surgery, and pharmacotherapy. Understanding the role of EAT may contribute to the development of more effective therapeutic strategies for the treatment of cardiovascular disease. It is presumed that EAT volume reduction may be beneficial for the heart, and cardiometabolic drugs may be a potentially effective therapy, but they require further research to confirm their efficacy and safety.
Keywords: epicardial Adipose TissueCardiovascular diseasesHeart Failure
References
- Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J. 2007; 153(6): 907–917.
- Iacobellis G, Bianco AC. Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features. Trends Endocrinol Metab. 2011; 22(11): 450–457.
- Corradi D, Maestri R, Callegari S, et al. The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts. Cardiovasc Pathol. 2004; 13(6): 313–316.
- Czy grozi Ci choroba wieńcowa? https://pacjent.gov.pl/zapobiegaj/czy-grozi-ci-choroba-wiencowa (07.05.2024).
- Lelonek M. Niewydolność serca i powtarzające się hospitalizacje. Folia Cardiologica. 2016; 11(1): 37–46.
- Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev. 2007; 8(3): 253–261.
- Bambace C, Telesca M, Zoico E, et al. Adiponectin gene expression and adipocyte diameter: a comparison between epicardial and subcutaneous adipose tissue in men. Cardiovasc Pathol. 2011; 20(5): e153–e156.
- Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005; 2(10): 536–543.
- Keegan J, Gatehouse PD, Yang GZ, et al. Spiral phase velocity mapping of left and right coronary artery blood flow: correction for through-plane motion using selective fat-only excitation. J Magn Reson Imaging. 2004; 20(6): 953–960.
- Gaborit B, Sengenes C, Ancel P, et al. Role of epicardial adipose tissue in health and disease: a matter of fat? Compr Physiol. 2017; 7(3): 1051–1082.
- van Woerden G, Gorter TM, Westenbrink BD, et al. Epicardial fat in heart failure patients with mid-range and preserved ejection fraction. Eur J Heart Fail. 2018; 20(11): 1559–1566.
- McAninch EA, Fonseca TL, Poggioli R, et al. Epicardial adipose tissue has a unique transcriptome modified in severe coronary artery disease. Obesity (Silver Spring). 2015; 23(6): 1267–1278.
- Patel VB, Mori J, McLean BA, et al. ACE2 Deficiency Worsens Epicardial Adipose Tissue Inflammation and Cardiac Dysfunction in Response to Diet-Induced Obesity. Diabetes. 2016; 65(1): 85–95.
- Doesch C, Haghi D, Flüchter S, et al. Epicardial adipose tissue in patients with heart failure. J Cardiovasc Magn Reson. 2010; 12(1): 40.
- Mancio J, Azevedo D, Saraiva F, et al. Epicardial adipose tissue volume assessed by computed tomography and coronary artery disease: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging. 2018; 19(5): 490–497.
- Wu A, Yang Z, Zhang X, et al. Association between epicardial adipose tissue and left atrial and ventricular function in patients with heart failure: a systematic review and meta-analysis. Curr Probl Cardiol. 2023; 48(12): 101979.
- Wu CK, Lee JK, Hsu JC, et al. Myocardial adipose deposition and the development of heart failure with preserved ejection fraction. Eur J Heart Fail. 2020; 22(3): 445–454.
- Maass AH, Westenbrink BD. Cardiac resynchronization therapy in mild heart failure should be reserved for true dyssynchronopathy. Eur J Heart Fail. 2015; 17(3): 239–241.
- Correia ET, Barbetta LM, Costa OS, et al. Epicardial adipose tissue in heart failure phenotypes - a meta-analysis. Arq Bras Cardiol. 2022; 118(3): 625–633.
- van Woerden G, van Veldhuisen DJ, Westenbrink BD, et al. Connecting epicardial adipose tissue and heart failure with preserved ejection fraction: mechanisms, management and modern perspectives. Eur J Heart Fail. 2022; 24(12): 2238–2250.
- Davidovich D, Gastaldelli A, Sicari R. Imaging cardiac fat. Eur Heart J Cardiovasc Imaging. 2013; 14(7): 625–630.
- Monti CB, Codari M, De Cecco CN, et al. Novel imaging biomarkers: epicardial adipose tissue evaluation. Br J Radiol. 2020; 93(1113): 20190770.
- Iacobellis G, Singh N, Wharton S, et al. Substantial changes in epicardial fat thickness after weight loss in severely obese subjects. Obesity (Silver Spring). 2008; 16(7): 1693–1697.
- Myasoedova VA, Parisi V, Moschetta D, et al. Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue: a systematic review and meta-analysis. Cardiovasc Diabetol. 2023; 22(1): 23.