Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, AB, T6G 2S2, Canada.
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Heart Fail Rev. 2017 Nov;22(6):889-902. doi: 10.1007/s10741-017-9644-1.
Obesity and diabetes are strongly associated with metabolic and cardiovascular disorders including dyslipidemia, coronary artery disease, hypertension, and heart failure. Adipose tissue is identified as a complex endocrine organ, which by exerting a wide array of regulatory functions at the cellular, tissue and systemic levels can have profound effects on the cardiovascular system. Different terms including "epicardial," "pericardial," and "paracardial" have been used to describe adipose tissue deposits surrounding the heart. Epicardial adipose tissue (EAT) is a unique and multifaceted fat depot with local and systemic effects. The functional and anatomic proximity of EAT to the myocardium enables endocrine, paracrine, and vasocrine effects on the heart. EAT displays a large secretosome, which regulates physiological and pathophysiological processes in the heart. Perivascular adipose tissue (PVAT) secretes adipose-derived relaxing factor, which is a "cocktail" of cytokines, adipokines, microRNAs, and cellular mediators, with a potent effect on paracrine regulation of vascular tone, vascular smooth muscle cell proliferation, migration, atherosclerosis-susceptibility, and restenosis. Although there are various physiological functions of the EAT and PVAT, a phenotypic transformation can lead to a major pathogenic role in various cardiovascular diseases. The equilibrium between the physiological and pathophysiological properties of EAT is very delicate and susceptible to the influences of intrinsic and extrinsic factors. Various adipokines secreted from EAT and PVAT have a profound effect on the myocardium and coronary arteries; targeting these adipokines could be an important therapeutic approach to counteract cardiovascular disease.
肥胖症和糖尿病与代谢和心血管疾病密切相关，包括血脂异常、冠心病、高血压和心力衰竭。脂肪组织被认为是一种复杂的内分泌器官，它通过在细胞、组织和系统水平上发挥广泛的调节功能，对心血管系统有深远的影响。不同的术语，如“心外膜”、“心包”和“心旁”，被用来描述围绕心脏的脂肪组织沉积。心外膜脂肪组织（EAT）是一种独特的、多方面的脂肪库，具有局部和全身作用。EAT 与心肌的功能和解剖接近，使其能够对心脏产生内分泌、旁分泌和血管分泌作用。EAT 显示出大量的分泌小体，调节心脏的生理和病理生理过程。血管周围脂肪组织（PVAT）分泌脂肪衍生的舒张因子，它是一种细胞因子、脂肪因子、microRNAs 和细胞介质的“鸡尾酒”，对血管张力的旁分泌调节、血管平滑肌细胞增殖、迁移、动脉粥样硬化易感性和再狭窄具有强大的作用。尽管 EAT 和 PVAT 具有各种生理功能，但表型转化可能导致各种心血管疾病的主要致病作用。EAT 的生理和病理生理特性之间的平衡非常微妙，容易受到内在和外在因素的影响。EAT 和 PVAT 分泌的各种脂肪因子对心肌和冠状动脉有深远的影响；针对这些脂肪因子可能是对抗心血管疾病的重要治疗方法。
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