[Epicardial fatty tissue of the right ventricle--morphology, morphometry and functional significance]

The height (thickness) of epicardial fat has been measured in histological slides at 10 standard "measuring points" in 200 human hearts. The 172 male and 28 female hearts were obtained from unselected autopsy material of the Institut of Pathology of the hospital groups "Bergmannsheil" in Bochum. The thickness of the epicardial fat on the surface of the right ventricle varies in histological paraffin slides between 0 and 13.6 mm. The mean of all 2,000 measurements is 2.19 mm, the median 1.7 mm. The mean values of the measurements at each of the standard points ranges between 0.851 mm at point No. 6 (dorso-caudal at the middle of the septum) and 4.12 mm at point No. 2 (sharp heart edge close to the bases). The lowest mean figure of the fat layer thickness is found in the dorso-caudal (diaphragmatic) region of the ventricular wall alongside the septum. At this point 0 thickness (fat-free area) is observed most frequently. The highest mean value and also the highest absolute measurement of fat layer thickness are found along the sharp heart edge - the ventro-lateral edge of the right ventricle - decrease from the heart bases to the apex. The average values of the standard "measuring points" along the ventral surface of the ventricular wall which decrease gradually from the heart bases to the apex, lie somewhere between the average values of the test points of the ventricle edge and the dorso-caudal surface close to the septum. In women, the epicardial fat layer on the right ventricle is, on average, thicker than that in men - ratio 1.65:1. A correlation can be seen between the thickness of the subcutaneous and epicardial fatty tissue layers. The weight of the ventricle wall can be increased in the case of marked fat development, and in exceptional cases the whole heart weight may be positively affected. Between age of 40 and death the thickness of the epicardial fat generally undergoes no statistical change. There is no statistical influence of the thickness of epicardial fat on the age at death, no is there any correlation between cause of death and thickness of the epicardial fat, and the epicardial fat is not diminished in deceased cancer patients. In the case of hypertrophy of the right ventricle there are no differences in the thickness of the fat layer as compared with the non-hypertrophic left ventricle. Chronic decompensated insufficiency of the right ventricle is associated with thinning of the fatty layer. No relationship is found between epicardial fat layer thickness and pathological silicosis in ex-miners.