Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Pacing Clin Electrophysiol. 2020 Jan;43(1):133-145. doi: 10.1111/pace.13825. Epub 2019 Nov 11.
Obesity plays an important role in the pathogenesis of atrial fibrillation (AF). Recently, rather than general fat distribution, epicardial adipose tissue (EAT) gains a growing concern. EAT is the local adipose deposition between myocardium and pericardium. Accumulated evidence revealed several distinguishing characteristics of EAT. It lies contiguously with the myocardium and could infiltration into myocardium, actively secrets cytokines and adipokines mediating inflammation or remodeling, and contains abundant ganglionated plexi. Clinical research also found EAT may be an independent risk factor of AF. Volume or thickness of EAT measured on CT or MRI could be applied as a predictor of presence, severity, and recurrence of AF. Some drugs, like antidiabetic drugs and lipid-lowing drugs, show ability to reduce EAT. Additional surgical ablation of EAT was also proved that it could improve outcome of pulmonary vein isolation for AF. In present review, we summarize recent epidemic, biological, and clinical findings about EAT and its possible role in AF.
肥胖在心房颤动（AF）的发病机制中起重要作用。最近，人们越来越关注心外膜脂肪组织（EAT），而不是一般的脂肪分布。EAT 是心肌和心包之间的局部脂肪沉积。越来越多的证据揭示了 EAT 的几个区别特征。它与心肌相邻，可以浸润到心肌中，积极分泌细胞因子和脂肪因子，介导炎症或重塑，并且含有丰富的神经节丛。临床研究还发现 EAT 可能是 AF 的一个独立危险因素。CT 或 MRI 测量的 EAT 体积或厚度可作为 AF 存在、严重程度和复发的预测指标。一些药物，如降糖药和降脂药，具有减少 EAT 的作用。额外的 EAT 手术消融也被证明可以改善 AF 的肺静脉隔离的效果。在本综述中，我们总结了 EAT 的最新流行病学、生物学和临床研究结果及其在 AF 中的可能作用。
