Potential Mechanisms of Epicardial Adipose Tissue Influencing Heart Failure with Preserved Ejection Fraction

Area of Science:

• Cardiology
• Metabolic Diseases
• Physiology

Background:

• Heart failure with preserved ejection fraction (HFpEF) is a growing global health concern, affecting approximately 50% of heart failure patients.
• The aging population contributes to the increasing prevalence, morbidity, and mortality associated with HFpEF.
• Epicardial adipose tissue (EAT), a visceral fat depot surrounding the heart, influences cardiac function, particularly diastolic function and exercise capacity.

Purpose of the Study:

• To comprehensively review the potential mechanisms by which EAT influences the development and progression of HFpEF.
• To explore the role of EAT in HFpEF, especially when co-occurring with metabolic diseases like obesity and diabetes.
• To enhance the understanding and management strategies for HFpEF.

Main Methods:

• This review synthesizes current research on the multifaceted roles of EAT in cardiac health.
• It examines EAT's paracrine and autocrine functions, including the production of inflammatory factors and neurotransmitters.
• The review considers EAT's impact on cardiac metabolism, cardiomyocyte structure, electrical activity, and pericardial vascular function.

Main Results:

• EAT exerts multi-level effects on the heart, influencing inflammatory responses, energy metabolism, and cardiomyocyte integrity.
• EAT's contribution to HFpEF is potentially exacerbated by co-existing metabolic conditions such as obesity and diabetes.
• The review highlights the complex interplay between EAT and HFpEF pathophysiology.

Conclusions:

• EAT is implicated as a significant factor in the pathogenesis of HFpEF.
• Further research into the mechanistic links between EAT and HFpEF is crucial.
• Targeting EAT presents a potential therapeutic avenue for improving HFpEF patient outcomes.