Dr. Pirek's Clinic, Mlada Boleslav, Czech Republic.
1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Curr Pharm Des. 2018;24(3):297-309. doi: 10.2174/1381612824666180110102125.
Epicardial adipose tissue is not only a specific adipose tissue depot but also an active endocrine organ producing numerous substances with an important role in the development of obesity-related heart diseases. It is located between myocardium and visceral pericardium and consists predominantly of adipocytes, immunocompetent cells, ganglia and interconnecting nerve branches. Several studies documented a positive correlation between pericardial and epicardial fat and left ventricular hypertrophy and septal thickening, leading to diastolic dysfunction, electrocardiographic abnormalities and facilitating cardiac failure. The cellular cross-talks between epicardial fat and myocardium may include both the vasocrine and the paracrine mechanisms. Adipokines secreted from epicardial adipose tissue, vascular and stromal cells diffuse into interstitial fluid crossing the adventitia, media and intima and modulate cardiac function and cardiomyocyte phenotype and survival. In this article, we review the significance of epicardial adipose tissue and its association with cardiovascular diseases, cellular interactions between epicardial fat and myocardium, secretions of adipokines and inflammatory mediators and a potential of epicardial fat as a therapeutic target for the prevention of obesity-related heart diseases.
心外膜脂肪组织不仅是一种特殊的脂肪组织库，还是一种活跃的内分泌器官，产生许多物质，在肥胖相关心脏病的发展中具有重要作用。它位于心肌和内脏心包之间，主要由脂肪细胞、免疫细胞、神经节和相互连接的神经分支组成。多项研究表明，心外膜和心外膜脂肪与左心室肥厚和室间隔增厚之间存在正相关，导致舒张功能障碍、心电图异常和心力衰竭。心外膜脂肪与心肌之间的细胞串扰可能包括血管内分泌和旁分泌机制。心外膜脂肪组织、血管和基质细胞分泌的脂肪因子扩散到间质液中，穿过外膜、中膜和内膜，调节心脏功能和心肌细胞表型并促进其存活。在本文中，我们回顾了心外膜脂肪组织的意义及其与心血管疾病的关系、心外膜脂肪与心肌之间的细胞相互作用、脂肪因子和炎症介质的分泌以及心外膜脂肪作为预防肥胖相关心脏病的治疗靶点的潜力。
