Advertisement

Anatomy of the Epicardial Adipose Tissue

  • Gianluca IacobellisEmail author
Chapter
  • 10 Downloads
Part of the Contemporary Cardiology book series (CONCARD)

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.

Keywords

Epicardial fat Epicardial adipose tissue Epicardial fat anatomy Epicardial fat embryology 

References

  1. 1.
    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.CrossRefGoogle Scholar
  2. 2.
    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.CrossRefGoogle Scholar
  3. 3.
    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.CrossRefGoogle Scholar
  4. 4.
    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.CrossRefGoogle Scholar
  5. 5.
    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.CrossRefGoogle Scholar
  6. 6.
    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.CrossRefGoogle Scholar
  7. 7.
    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.CrossRefGoogle Scholar
  8. 8.
    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.CrossRefGoogle Scholar
  9. 9.
    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.CrossRefGoogle Scholar
  10. 10.
    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.CrossRefGoogle Scholar
  11. 11.
    Iacobellis G. Epicardial and pericardial fat: close, but very different. Obesity (Silver Spring). 2009;17:625; author reply 626–7.CrossRefGoogle Scholar
  12. 12.
    Ho E, Shimada Y. Formation of the epicardium studied with the scanning electron microscope. Dev Biol. 1978;66:579–85.CrossRefGoogle Scholar
  13. 13.
    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.CrossRefGoogle Scholar
  14. 14.
    Virágh S, Challice CE. The origin of the epicardium and the embryonic myocardial circulation in the mouse. Anat Rec. 1981;201:157–68.CrossRefGoogle Scholar
  15. 15.
    Sucov HM, Gu Y, Thomas S, Li P, Pashmforoush M. Epicardial control of myocardial proliferation and morphogenesis. Pediatr Cardiol. 2009;30:617–25.CrossRefGoogle Scholar
  16. 16.
    Riley PR. An epicardial floor plan for building and rebuilding the mammalian heart. Curr Top Dev Biol. 2012;100:233–51.CrossRefGoogle Scholar
  17. 17.
    Acharya A. The bHLH transcription factor Tcf21 is required for lineage-specific EMT of cardiac fibroblast progenitors. Development. 2012;139:2139–49.CrossRefGoogle Scholar
  18. 18.
    Ojha S, et al. Gene pathway development in human epicardial adipose tissue during early life. JCI Insight. 2016;1:e87460.CrossRefGoogle Scholar
  19. 19.
    Arora RC, Waldmann M, Hopkins DA, Armour JA. Porcine intrinsic cardiac ganglia. Anat Rec A Discov Mol Cell Evol Biol. 2003;271:249–58.CrossRefGoogle Scholar
  20. 20.
    White IA. Cardiac sympathetic denervation in the failing heart: a role for epicardial adipose tissue. Circ Res. 2016;118:1189–91.CrossRefGoogle Scholar
  21. 21.
    Bambace C. Adiponectin gene expression and adipocyte diameter: a comparison between epicardial and subcutaneous adipose tissue in men. Cardiovasc Pathol. 2011;20:e153–6.CrossRefGoogle Scholar
  22. 22.
    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.CrossRefGoogle Scholar
  23. 23.
    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.CrossRefGoogle Scholar
  24. 24.
    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.CrossRefGoogle Scholar
  25. 25.
    Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol. 2015;11:363–71.CrossRefGoogle Scholar
  26. 26.
    Bedford E. The story of fatty heart. A disease of Victorian times. Br Heart J. 1972;34:23–8.CrossRefGoogle Scholar
  27. 27.
    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.Google Scholar
  28. 28.
    Rindfleisch E. Ueber klammenartige Verbindungen zwischen Aorta und Pulmonalis. Virchows Arch Pathol Anat Physiol Klin Med. 1884;96:302–6.CrossRefGoogle Scholar
  29. 29.
    Davis DJ. The periaortic fat bodies. Arch Pathol Lab Med. 1927;4:937–42.Google Scholar
  30. 30.
    Robertson HF. The vascularization of the epicardial and periaortic fat pads. Am J Pathol. 1930;6:209–15.PubMedPubMedCentralGoogle Scholar
  31. 31.
    De Kock LL. Histology of the carotid body. Nature. 1951;67:661.Google Scholar
  32. 32.
    De Kock LL, Dunn AE. An electron microscope study of the carotid body. Acta Anat (Basel). 1966;64:163–78.CrossRefGoogle Scholar
  33. 33.
    Ross LL. Electron microscopic observations of the carotid body of the cat. J Biophys Biochem Cytol. 1959;6:253–61.CrossRefGoogle Scholar
  34. 34.
    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.CrossRefGoogle Scholar
  35. 35.
    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.CrossRefGoogle Scholar
  36. 36.
    Dean JW, Ho SY, Rowland E, Mann J, Anderson RH. Clinical anatomy of the atrioventricular junctions. J Am Coll Cardiol. 1994;24:1725–31.CrossRefGoogle Scholar
  37. 37.
    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.CrossRefGoogle Scholar
  38. 38.
    Corradi D. The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts. Cardiovasc Pathol. 2004;13:313–6.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Endocrinology, Diabetes and Metabolism, Department of MedicineUniversity of Miami, Miller School of MedicineMiamiUSA

Personalised recommendations