Abstract
Epicardial adipose tissue (EAT) is the fat depot located between the myocardium and the epicardium including the surroundings of the epicardial coronary vessels while the pericardial fat is located externally. Epicardial and intra-abdominal fat both evolve from brown adipose tissue. EAT is supplied by branches of the coronary arteries, whereas pericardial fat is supplied by branches of non-coronary arteries. In the adult human heart, EAT is more abundant in the atrioventricular and interventricular grooves. Microscopically, EAT not only is mainly composed of adipocytes but also contains nerve tissues, inflammatory, stromovascular, and immune cells. EAT is generally considered a white adipose tissue, albeit it displays also brown fatlike or beige fat features. No muscle fascia divides EAT and myocardium; therefore, the two tissues share the same microcirculation. This allows a direct interaction and crosstalk between the EAT and the myocardium. Under pathological circumstances, epicardial adipocytes display an intrinsic pro-inflammatory and atherogenic profile. A dense inflammatory infiltrate, mainly represented by macrophages, is commonly detected in epicardial fat of subjects with coronary artery disease.
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References
Iacobellis G, Assael F, Ribaudo MC, Zappaterreno A, Alessi G, Di Mario U, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003;11:304–10.
Henry BA, Pope M, Birtwistle M, Loughnan R, Alagal R, Fuller-Jackson JP, et al. Ontogeny and thermogenic role for sternal fat in female sheep. Endocrinology. 2017;158:2212–25.
Yamaguchi Y, Cavallero S, Patterson M, Shen H, Xu J, Kumar SR, et al. Adipogenesis and epicardial adipose tissue: a novel fate of the epicardium induced by mesenchymal transformation and PPARγ activation. Proc Natl Acad Sci U S A. 2015;112:2070–5.
Pond CM. The contribution of wild animal biology to human physiology and medicine: adipose tissue associated with lymphoid and cardiac tissues. Ecoscience. 2003;10:1–9.
Marchington JM, Mattacks CA, Pond CM. Adipose tissue in the mammalian heart and pericardium: structure, fetal development and biochemical properties. Comp Biochem Physiol B. 1989;94:225–32.
Braz JKFS, Freitas ML, Magalhães MS. Histology and immunohistochemistry of the cardiac ventricular structure in the green turtle (Chelonia mydas). Anat Histol Embryol. 2016;45:277–84.
Patel VB, Mori J, McLean BA, Basu R, Das SK, Ramprasath T, et al. ACE2 deficiency worsens epicardial adipose tissue inflammation and cardiac dysfunction in response to diet-induced obesity. Diabetes. 2016;65:85–95.
McKenney-Drake ML, Rodenbeck SD, Bruning RS, Kole A, Yancey KW, Alloosh M, et al. Epicardial adipose tissue removal potentiates outward remodeling and arrests coronary atherogenesis. Ann Thorac Surg. 2017;103:1622–30.
Fainberg HP, Birtwistle M, Alagal R, Alhaddad A, Pope M, Davies G, et al. Transcriptional analysis of adipose tissue during development reveals depot-specific responsiveness to maternal dietary supplementation. Sci Rep. 2018;8:9628.
Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005;2:536–43.
Iacobellis G. Epicardial and pericardial fat: close, but very different. Obesity (Silver Spring). 2009;17:625; author reply 626–7.
Ho E, Shimada Y. Formation of the epicardium studied with the scanning electron microscope. Dev Biol. 1978;66:579–85.
Walden TB, Hansen IR, Timmons JA, Cannon B, Nedergaard J. Recruited vs. nonrecruited molecular signatures of brown, “brite,” and white adipose tissues. Am J Physiol Endocrinol Metab. 2012;302:E19–31.
Virágh S, Challice CE. The origin of the epicardium and the embryonic myocardial circulation in the mouse. Anat Rec. 1981;201:157–68.
Sucov HM, Gu Y, Thomas S, Li P, Pashmforoush M. Epicardial control of myocardial proliferation and morphogenesis. Pediatr Cardiol. 2009;30:617–25.
Riley PR. An epicardial floor plan for building and rebuilding the mammalian heart. Curr Top Dev Biol. 2012;100:233–51.
Acharya A. The bHLH transcription factor Tcf21 is required for lineage-specific EMT of cardiac fibroblast progenitors. Development. 2012;139:2139–49.
Ojha S, et al. Gene pathway development in human epicardial adipose tissue during early life. JCI Insight. 2016;1:e87460.
Arora RC, Waldmann M, Hopkins DA, Armour JA. Porcine intrinsic cardiac ganglia. Anat Rec A Discov Mol Cell Evol Biol. 2003;271:249–58.
White IA. Cardiac sympathetic denervation in the failing heart: a role for epicardial adipose tissue. Circ Res. 2016;118:1189–91.
Bambace C. Adiponectin gene expression and adipocyte diameter: a comparison between epicardial and subcutaneous adipose tissue in men. Cardiovasc Pathol. 2011;20:e153–6.
Sacks HS, Fain JN, Bahouth SW, Ojha S, Frontini A, Budge H, et al. Human epicardial fat exhibits beige features. J Clin Endocrinol Metab. 2013;98:E1448–55.
Wu J, Boström P, Sparks LM, Ye L, Choi JH, Giang AH, et al. Beige adipocytes are a distinct type of thermogenic fat cell in mouse and human. Cell. 2012;150:366–76.
Company JM, Booth FW, Laughlin MH, Arce-Esquivel AA, Sacks HS, Bahouth SW, et al. Epicardial fat gene expression after aerobic exercise training in pigs with coronary atherosclerosis: relationship to visceral and subcutaneous fat. J Appl Physiol. 2010;109:1904–1.
Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol. 2015;11:363–71.
Bedford E. The story of fatty heart. A disease of Victorian times. Br Heart J. 1972;34:23–8.
The collected works of Dr. P. M. Latham, with memoir by Sir Thomas Watson. Edited for the society by R. Martin. Vol. 69; London: The New Sydenham Society; 1876–78.
Rindfleisch E. Ueber klammenartige Verbindungen zwischen Aorta und Pulmonalis. Virchows Arch Pathol Anat Physiol Klin Med. 1884;96:302–6.
Davis DJ. The periaortic fat bodies. Arch Pathol Lab Med. 1927;4:937–42.
Robertson HF. The vascularization of the epicardial and periaortic fat pads. Am J Pathol. 1930;6:209–15.
De Kock LL. Histology of the carotid body. Nature. 1951;67:661.
De Kock LL, Dunn AE. An electron microscope study of the carotid body. Acta Anat (Basel). 1966;64:163–78.
Ross LL. Electron microscopic observations of the carotid body of the cat. J Biophys Biochem Cytol. 1959;6:253–61.
Leo LA, Paiocchi VL, Schlossbauer SA, Ho SY, Faletra FF. The intrusive nature of epicardial adipose tissue as revealed by cardiac magnetic resonance. J Cardiovasc Echography. 2019;29:45–51.
Faletra FF, Leo LA, Paiocchi VL, Schlossbauer SA, Borruso MG, Pedrazzini G, et al. Imaging-based tricuspid valve anatomy by computed tomography, magnetic resonance imaging, two and three-dimensional echocardiography: correlation with anatomic specimen. Eur Heart J Cardiovasc Imaging. 2019;20:1–3.
Dean JW, Ho SY, Rowland E, Mann J, Anderson RH. Clinical anatomy of the atrioventricular junctions. J Am Coll Cardiol. 1994;24:1725–31.
McKenney ML, Schultz KA, Boyd JH, Byrd JP, Alloosh M, Teague SD, et al. Epicardial adipose excision slows the progression of porcine coronary atherosclerosis. J Cardiothorac Surg. 2014;9:2.
Corradi D. The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts. Cardiovasc Pathol. 2004;13:313–6.
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Iacobellis, G. (2020). Anatomy of the Epicardial Adipose Tissue. In: Iacobellis, G. (eds) Epicardial Adipose Tissue. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-030-40570-0_1
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