The roles of epicardial adipose tissue in heart failure


Heart failure is a growing health problem resulting in the decreased life expectancy of patients and severely increased the healthcare burden. Penetrating research on the pathogenesis and regulation mechanism of heart failure is important for treatment of heart failure. Epicardial adipose tissue (EAT) has been demonstrated as not only a dynamic organ with biological functions but also an inert lipid store with regulating systemic metabolism. EAT mediates physiological and pathophysiological processes of heart failure by regulating adipogenesis, cardiac remodeling, insulin resistance, cardiac output, and renin angiotensin aldosterone system (RAAS). Moreover, EAT secretes a wide range of adipokines, adrenomedullin, adiponectin, and miRNAs through paracrine, endocrine, and vasocrine pathways, which involve in various extracellular and intracellular mechanism of cardiac-related cells in the progress of cardiovascular disease especially in heart failure. Nevertheless, mechanisms and roles of EAT on heart failure are barely summarized. Understanding the regulating mechanisms of EAT on heart failure may give rise to novel therapeutic targets and will open up innovative strategies to myocardial injury as well as in heart failure.

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Fig. 1



Epicardial adipose tissue


Renin angiotensin aldosterone system


White adipose tissue


Brown adipose tissue


Free fatty acid


Left ventricle


Body mass index


Heart failure with preserved ejection fraction


Heart failure patients with reduced ejection fraction


Reactive oxygen species




Cyclic adenosine monophosphate


Nitric oxide




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This study was supported by a Joint Fund for Science and Technology Cooperation across the Taiwan Straits from the National Natural Science Foundation and Fujian Province, China (Grant No. U1605226), and a Science and Technology Project from Xiamen Science and Technology Bureau, Fujian Province, China (Grant No. 3502Z20184025).

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Song, Y., Song, F., Wu, C. et al. The roles of epicardial adipose tissue in heart failure. Heart Fail Rev (2020).

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  • Epicardial adipose tissue
  • Heart failure
  • Adipokines
  • Adrenomedullin
  • MicroRNAs