Heart Failure Reviews

, Volume 22, Issue 6, pp 889–902 | Cite as

Epicardial adipose tissue as a metabolic transducer: role in heart failure and coronary artery disease

  • Vaibhav B. Patel
  • Saumya Shah
  • Subodh Verma
  • Gavin Y. Oudit
Article
First Online:

Abstract

Obesity and diabetes are strongly associated with metabolic and cardiovascular disorders including dyslipidemia, coronary artery disease, hypertension, and heart failure. Adipose tissue is identified as a complex endocrine organ, which by exerting a wide array of regulatory functions at the cellular, tissue and systemic levels can have profound effects on the cardiovascular system. Different terms including “epicardial,” “pericardial,” and “paracardial” have been used to describe adipose tissue deposits surrounding the heart. Epicardial adipose tissue (EAT) is a unique and multifaceted fat depot with local and systemic effects. The functional and anatomic proximity of EAT to the myocardium enables endocrine, paracrine, and vasocrine effects on the heart. EAT displays a large secretosome, which regulates physiological and pathophysiological processes in the heart. Perivascular adipose tissue (PVAT) secretes adipose-derived relaxing factor, which is a “cocktail” of cytokines, adipokines, microRNAs, and cellular mediators, with a potent effect on paracrine regulation of vascular tone, vascular smooth muscle cell proliferation, migration, atherosclerosis-susceptibility, and restenosis. Although there are various physiological functions of the EAT and PVAT, a phenotypic transformation can lead to a major pathogenic role in various cardiovascular diseases. The equilibrium between the physiological and pathophysiological properties of EAT is very delicate and susceptible to the influences of intrinsic and extrinsic factors. Various adipokines secreted from EAT and PVAT have a profound effect on the myocardium and coronary arteries; targeting these adipokines could be an important therapeutic approach to counteract cardiovascular disease.

Keywords

Heart failure Obesity Adipose tissue 

Abbreviations

ACE2

Angiotensin-converting enzyme 2

ADRF

Adipocyte derived-relaxing factor

Ang

Angiotensin

ATM

Adipose tissue macrophages

BAT

Brown adipose tissue

CAD

Coronary artery disease

CMR

Cardiac magnetic resonance

CT

Computed tomography

EAT

Epicardial adipose tissue

H202

Hydrogen peroxide (H202)

H2S

Hydrogen sulfide

HF-pEF

Heart failure with preserved ejection fraction

JNK

c-Jun N-terminal kinase

MCP-1

Monocyte chemoattractant protein-1

NF-κB

Nuclear factor κβ

NO

Nitric oxide

PVAT

Perivascular adipose tissue

TLR

Toll-like receptor

TNF-α

Tumor necrosis factor

UCP1

Uncoupling protein 1

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Notes

Acknowledgements

VBP received support from AI-HS and Heart and Stroke Foundation (HSF) Post-Doctoral Fellowships.

Compliance with ethical standards

Funding

We acknowledge funding support from Canadian Institutes of Health Research (CIHR) (grant number 88341) and Alberta Innovates-Health Solutions (AI-HS) (grant number 1742).

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Vaibhav B. Patel
    • 1
    • 2
    • 3
  • Saumya Shah
    • 1
    • 2
  • Subodh Verma
    • 4
    • 5
    • 6
  • Gavin Y. Oudit
    • 1
    • 2
    • 7
  1. 1.Division of Cardiology, Department of MedicineUniversity of AlbertaEdmontonCanada
  2. 2.Mazankowski Alberta Heart InstituteUniversity of AlbertaEdmontonCanada
  3. 3.Department of Physiology and Pharmacology and Libin Cardiovascular Institute of Alberta, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
  4. 4.Division of Cardiac Surgery, Keenan Research Centre for Biomedical ScienceSt. Michael’s HospitalTorontoCanada
  5. 5.Department of SurgeryUniversity of TorontoTorontoCanada
  6. 6.Institute of Medical ScienceUniversity of TorontoTorontoCanada
  7. 7.Department of PhysiologyUniversity of AlbertaEdmontonCanada

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