Abstract
Background: Epicardial adipose tissue (EAT) is a visceral fat depot with unique anatomic, biomolecular and genetic features. Due to its proximity to the coronary arteries and myocardium, dysfunctional EAT may contribute to the development and progression of cardiovascular and metabolic-related adiposity-based chronic diseases. The aim of this work was to describe, by morphological techniques, the early origin of EAT. Methods: EAT adipogenesis was studied in 41 embryos from 32 gestational days (GD) to 8 gestational weeks (GW) and in 23 fetuses until full term (from 9 to 36 GW). Results: This process comprises five stages. Stage 1 appears as mesenchyme at 33–35 GD. Stage 2 is characterized by angiogenesis at 42–45 GD. Stage 3 covers up to 34 GW with the appearance of small fibers in the extracellular matrix. Stage 4 is visible around the coronary arteries, as multilocular adipocytes in primitive fat lobules, and Stage 5 is present with unilocular adipocytes in the definitive fat lobules. EAT precursor tissue appears as early as the end of the first gestational month in the atrioventricular grooves. Unilocular adipocytes appear at the eighth gestational month. Conclusions: Due to its early origin, plasticity and clinical implications, factors such as maternal health and nutrition might influence EAT early development in consequence.
Highlights
The heart wall consists of an endocardial inner layer, a contractile myocardium and the outer cover, the epicardium
Appears in the embryonic period as early as the beginning of the second gestational month appears in the embryonic period as early as the beginning of the second gestational month, and unilocular adipocytes are present at the eighth gestational
In view of our results, precursor tissue of Epicardial adipose tissue (EAT) appears in the embryonic period as early as the beginning of the second gestational month, and unilocular adipocytes are present at the eighth gestational month
Summary
The heart wall consists of an endocardial inner layer, a contractile myocardium and the outer cover, the epicardium. The epicardium is a complex of layers with a flat mesothelium connected to the myocardium by subepicardial loose connective tissue, where a large amount of white adipose tissue (AT) accumulates, forming the so-called epicardial adipose tissue (EAT) [1]. The epicardium has emerged as a multipotent cardiovascular progenitor source with therapeutic potential for coronary smooth muscle cell, cardiac fibroblast and cardiomyocyte regeneration, owing to its fundamental role in heart development and its potential ability to initiate myocardial repair in injured adult tissues [3]. EAT, located within the pericardium, directly overlays the myocardium and coronary vessels and houses the intrinsic cardiac nervous system ganglia and plexi. Due to its proximity to the coronary arteries and myocardium, dysfunctional EAT may contribute to the development and progression of cardiovascular and metabolic-related adiposity-based chronic diseases.
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