Anatomy of the Epicardial Adipose Tissue
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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.
KeywordsEpicardial fat Epicardial adipose tissue Epicardial fat anatomy Epicardial fat embryology
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