Abstract
Anatomical evidence in several species shows highly heterogeneous fat distribution in the atrial and ventricular myocardium. Atrial appendages have fat deposits, and more so on the posterior left atrium. Although such fat distributions are considered normal, fatty infiltration is regarded arrhythmogenic, and various cardiac pathophysiological conditions show excess myocardial fat deposits, especially in the epicardium. Hypotheses have been presented for the physiological and pathophysiological roles of epicardial fat, however this issue is poorly understood. Therefore, this mini-review will focus on epicardial fat distribution and the (patho)-physiological implications of this distribution. Potential molecular mechanisms that may drive structural and electrical myocardial remodeling attendant to fatty infiltration of the heart are also reviewed.
Highlights
Specialty section: This article was submitted to Cardiac Electrophysiology, a section of the journal Frontiers in Physiology
Epicardial adipose tissue (EAT) is increased in myocardial diseases, an increase that is associated with arrhythmogenicity (Sacks and Fain, 2007; Christensen et al, 2008; Sen-Chowdhry et al, 2010; Deshpande et al, 2016; Samanta et al, 2016)
Depending on-physiological conditions, these cells have been shown to release several of biofactors, including cytokines and free fatty acid, which are demonstrably capable of myocardial remodeling
Summary
Such fat distributions are considered normal, fatty infiltration is regarded arrhythmogenic, and various cardiac pathophysiological conditions show excess myocardial fat deposits, especially in the epicardium. Potential molecular mechanisms that may drive structural and electrical myocardial remodeling attendant to fatty infiltration of the heart are reviewed.
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