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Horm Metab Res 2013; 45(13): 991-1001
DOI: 10.1055/s-0033-1358669
Review
© Georg Thieme Verlag KG Stuttgart · New York

Epicardial Fat: More than Just an “Epi” Phenomenon?

B. Gaborit
1   Department of Endocrinology, Metabolic Diseases and Nutrition, CHU Nord, Marseille, France
2   Inserm U1062, Inra U1260, Faculté de Médecine, Marseille, France
3   Aix Marseille Université, Marseille, France
,
I. Abdesselam
2   Inserm U1062, Inra U1260, Faculté de Médecine, Marseille, France
3   Aix Marseille Université, Marseille, France
4   CNRS Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339, Marseille, France
,
A. Dutour
1   Department of Endocrinology, Metabolic Diseases and Nutrition, CHU Nord, Marseille, France
2   Inserm U1062, Inra U1260, Faculté de Médecine, Marseille, France
3   Aix Marseille Université, Marseille, France
› Author Affiliations
Further Information

Publication History

received 27 May 2013

accepted 30 September 2013

Publication Date:
11 November 2013 (online)

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Abstract

Regional body-fat distribution is one of the key variables that explains the metabolic heterogeneity of obesity and its related cardiovascular risks. According to the ectopy concept, the inability of subcutaneous adipose tissue to store surplus triglycerides may lead to the development of fat in ectopic sites, such as the heart. Epicardial adipose tissue is a metabolically active endocrine organ that produces numerous factors that can modulate cardiac structure and function. The development of in vivo noninvasive imaging has made it possible to quantify its thickness and volume with increasing accuracy. In this review, we discuss the local interaction and cross-talk between epicardial fat and neighboring structures, such as coronary arteries and myocardium, and its relevance to cardiac diseases, such as coronary-artery disease or atrial fibrillation. Beneficial and harmful effects of epicardial adipose tissue are described and analyzed. What leads to an imbalance between protective and deleterious actions has to be further explored. We believe that epicardial fat, which has been neglected for years, plays a key role in cardiovascular disease pathophysiology and represents a “new world” exploration for therapeutic targets, which will be addressed in future clinical and research studies. Elucidating the mechanisms that drive the deposition or mobilization of cardiac adiposity between other ectopic-fat stores needs to be accomplished within the next few years.

Key words

ectopy - obesity - ectopic fat - epicardial adipose tissue - coronary-artery disease - cardiac adiposity - myocardium
 

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