Human epicardial adipose tissue: a review

Area of Science:

• Cardiology
• Endocrinology
• Pathophysiology

Background:

• Epicardial adipose tissue (EAT) stores triglycerides and produces adipokines, crucial for myocardial energy and function.
• EAT shares embryological origins with visceral fat and shares similar increases in thickness with obesity.
• Unlike other fat depots, EAT lacks a fascial barrier, allowing direct diffusion of substances to the coronary arteries and myocardium.

Purpose of the Study:

• To discuss the anatomy, physiology, and pathophysiology of EAT.
• To explore the relationship between EAT and coronary atherosclerosis.
• To investigate the role of EAT-derived adipokines in coronary artery disease.

Main Methods:

• Review of existing literature on EAT anatomy, physiology, and pathophysiology.
• Analysis of EAT's role in coronary atherosclerosis based on observational studies.
• Examination of adipokine and cytokine expression in EAT from patients with and without coronary atherosclerosis.

Main Results:

• EAT thickness increases with obesity, similar to visceral fat.
• EAT proximity to coronary arteries facilitates local diffusion of free fatty acids and adipokines, influencing atherogenesis.
• Macrophages infiltrate EAT in atherosclerotic coronary arteries, and EAT secretes proinflammatory cytokines, especially in obese patients.

Conclusions:

• EAT plays a significant role in the local pathogenesis of coronary atherosclerosis.
• Adipokines produced by EAT may contribute to coronary artery disease development.
• Further research is needed to confirm the role of EAT-derived adipokines in human coronary atherosclerosis.