Epicardial adipose tissue is an unusual visceral fat depot with anatomical and functional contiguity to the myo- cardium and coronary arteries. Under physiological con- ditions, epicardial adipose tissue displays biochemical, mechanical and thermogenic cardioprotective proper- ties. Under pathological circumstances, epicardial fat can locally affect the heart and coronary arteries through vasocrine or paracrine secretion of proinflammatory cytokines. What influences this equilibrium remains un- clear. Improved local vascularization, weight loss, and targeted pharmaceutical interventions could help to re- turn epicardial fat to its physiological role. This review focuses on the emerging physiological and pathophysi- ological aspects of the epicardial fat and its numerous and innovative clinical applications. Particular emphasis is placed on the paracrine/endocrine properties of epicardial fat and its role in the development and pro- gression of atherosclerosis.

Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features.

Gianluca Iacobellis and Antonio C. Bianco. Trends in Endocrinology and Metabolism. November, 2011. PMID: 21852149

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