Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Internal Medicine Unit and Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy.
Acta Diabetol. 2017 Sep;54(9):805-812. doi: 10.1007/s00592-017-1020-z. Epub 2017 Jun 29.
In recent years, the anatomic and functional contiguity of epicardial adipose tissue (EAT) to myocardium and coronary arteries has gained increasing interest for its potential pathogenetic role in obesity-related cardiac diseases. Besides its known and attributed biochemical cardioprotective properties, it is becoming evident that, in metabolic disease states, EAT-secreted bioactive molecules may play an important role in the pathogenesis of coronary artery disease and cardiac arrhythmias. EAT-derived inflammatory cytokines and reactive oxidative species may, indeed, play a part in the development of a local proatherogenic milieu by paracrine and vasocrine mechanisms of interaction. In addition, initial clinical and in vitro studies have pointed out that EAT could be a determinant of the substrate of atrial fibrillation by contributing to the structural and electrical remodeling of myocardium. This article reviews the current state of knowledge on the association of EAT with cardiac dysfunction and the potential factors mediating the cross talk between this fat depot and the underlying cardiac structures.
近年来，心外膜脂肪组织（EAT）与心肌和冠状动脉在解剖和功能上的连续性引起了越来越多的关注，因为它在心外膜脂肪组织与肥胖相关的心脏疾病中的潜在发病机制中具有重要作用。除了已知和归因于心外膜脂肪组织的生化心脏保护特性外，越来越明显的是，在代谢疾病状态下，EAT 分泌的生物活性分子可能在冠状动脉疾病和心律失常的发病机制中发挥重要作用。EAT 衍生的炎性细胞因子和活性氧化物质可能通过旁分泌和血管分泌相互作用机制在局部促动脉粥样硬化环境的发展中发挥作用。此外，初步的临床和体外研究指出，EAT 可能通过对心肌的结构和电重构来决定心房颤动的底物。本文综述了目前关于 EAT 与心脏功能障碍的相关性的知识状态，以及介导该脂肪库与潜在心脏结构之间串扰的潜在因素。
