Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA.
Trends Endocrinol Metab. 2011 Nov;22(11):450-7. doi: 10.1016/j.tem.2011.07.003. Epub 2011 Aug 16.
Epicardial adipose tissue is an unusual visceral fat depot with anatomical and functional contiguity to the myocardium and coronary arteries. Under physiological conditions, epicardial adipose tissue displays biochemical, mechanical and thermogenic cardioprotective properties. Under pathological circumstances, epicardial fat can locally affect the heart and coronary arteries through vasocrine or paracrine secretion of proinflammatory cytokines. What influences this equilibrium remains unclear. Improved local vascularization, weight loss, and targeted pharmaceutical interventions could help to return epicardial fat to its physiological role. This review focuses on the emerging physiological and pathophysiological aspects of the epicardial fat and its numerous and innovative clinical applications. Particular emphasis is placed on the paracrine/endocrine properties of epicardial fat and its role in the development and progression of atherosclerosis.
心外膜脂肪组织是一种特殊的内脏脂肪库，与心肌和冠状动脉在解剖和功能上具有连续性。在生理条件下，心外膜脂肪组织具有生化、力学和产热的心脏保护特性。在心外膜脂肪组织的功能改变和临床意义方面，病理条件下心外膜脂肪可通过促炎细胞因子的血管内分泌或旁分泌局部影响心脏和冠状动脉。目前尚不清楚是什么影响了这种平衡。改善局部血管化、减肥和靶向药物干预可能有助于使心外膜脂肪恢复其生理作用。本文重点介绍心外膜脂肪的新兴生理和病理生理方面及其众多创新的临床应用。特别强调心外膜脂肪的旁分泌/内分泌特性及其在动脉粥样硬化发生和进展中的作用。
