Epicardial fat, metabolic dysregulation, and cardiovascular risk: putting things together.

نویسندگان

  • Francisco López-Jiménez
  • Ondrej Sochor
چکیده

For several decades, pathologists observed that coronary atherosclerosis is generally limited to subepicardial segments and that intramyocardial coronary segments rarely show atherosclerosis. They also observed that pericardial fat is primarily located along the main coronary branches. These 2 observations led investigators to suspect and confirm a relationship between pericardial fat and coronary atherosclerosis. Obesity or excessive adipose tissue has long been related to cardiovascular disease and mortality. Epidemiologic studies have demonstrated that visceral fat, perhaps more than total fat, is implicated in atherosclerosis by indirect mechanisms–such as metabolic dysregulation—and obesity-related risk factors—such as systemic hypertension and dyslipidemia. Studies have also shown direct mechanisms linking obesity and cardiovascular disease, such as an increased free fatty acid circulation and cytokine production. More contemporary studies have demonstrated that pericardial fat, a type of ectopic visceral fat located around the heart either as subepicardial adipose tissue (intrapericardial) or outside the pericardium, has a high level of inflammatory markers and is metabolically active. Other studies have demonstrated that the pericardial fat of patients with atherosclerosis is more metabolically active than the fat of people without atherosclerotic coronary disease. Cross-sectional studies have shown an association between pericardial fat measured with echocardiography, computed tomography, or magnetic resonance and the presence and extent of coronary atherosclerosis, as well as an association between pericardial fat and decreased myocardial perfusion using nuclear stress tests. The epicardial fat in ventricles is related to myocardial mass not only in normal hearts, but also in hypertrophic or ischemic hearts. Studies have also shown that atrial septum thickness, which is mainly determined by the amount of subepicardial fat, is associated with coronary disease. Some reports, however, have failed to show an association between pericardial fat and coronary disease. A study published by

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عنوان ژورنال:
  • Revista espanola de cardiologia

دوره 67 6  شماره 

صفحات  -

تاریخ انتشار 2014