Toczyłowski Kacper, Gruca Michał, Baranowski Marcin
Zakład Fizjologii Uniwersytetu Medycznego w Białymstoku, Białymstok.
Postepy Hig Med Dosw (Online). 2013 Jun 20;67:584-93. doi: 10.5604/17322693.1053908.
Adipose tissue secretes a number of cytokines, referred to as adipokines. Intensive studies conducted over the last two decades showed that adipokines exert broad effects on cardiac metabolism and function. In addition, the available data strongly suggests that these cytokines play an important role in development of cardiovascular diseases. Epicardial adipose tissue (EAT) has special properties that distinguish it from other deposits of visceral fat. Overall, there appears to be a close functional and anatomic relationship between the EAT and the cardiac muscle. They share the same coronary blood supply, and there is no structure separating the adipose tissue from the myocardium or coronary arteries. The role of EAT in osierdziocardiac physiology remains unclear. Its putative functions include buffering coronary arteries against the torsion induced by the arterial pulse wave and cardiac contraction, regulating fatty acid homeostasis in the coronary microcirculation, thermogenesis, and neuroprotection of the cardiac autonomic ganglia and nerves. Obesity (particularly the abdominal phenotype) leads to elevated EAT content, and the available data suggests that high amount of this fat depot is associated with increased risk of ischemic heart disease, cardiac hypertrophy and diastolic dysfunction. The mass of EAT is small compared to other fat deposits in the body. Nevertheless, its close anatomic relationship to the heart suggests that this organ is highly exposed to EAT-derived adipokines which makes this tissue a very promising area of research. In this paper we review the current knowledge on the role of EAT in cardiac physiology and development of heart disease.
脂肪组织分泌多种细胞因子，称为脂肪因子。过去二十年进行的深入研究表明，脂肪因子对心脏代谢和功能具有广泛影响。此外，现有数据强烈表明这些细胞因子在心血管疾病的发展中起重要作用。心外膜脂肪组织（EAT）具有特殊性质，使其与其他内脏脂肪沉积区分开来。总体而言，EAT与心肌之间似乎存在密切的功能和解剖关系。它们共享相同的冠状动脉血液供应，并且没有结构将脂肪组织与心肌或冠状动脉分隔开。EAT在心脏生理中的作用仍不清楚。其假定功能包括缓冲冠状动脉免受动脉脉搏波和心脏收缩引起的扭转，调节冠状动脉微循环中的脂肪酸稳态，产热以及对心脏自主神经节和神经的神经保护。肥胖（特别是腹部肥胖表型）会导致EAT含量升高，现有数据表明，这种大量的脂肪库与缺血性心脏病、心脏肥大和舒张功能障碍的风险增加有关。与体内其他脂肪沉积相比，EAT的质量较小。然而，它与心脏密切的解剖关系表明，心脏高度暴露于源自EAT的脂肪因子，这使得该组织成为一个非常有前景的研究领域。在本文中，我们综述了关于EAT在心脏生理和心脏病发展中作用的当前知识。
