Inflammation and Cardiovascular Diseases in the Elderly: The Role of Epicardial Adipose Tissue

Conte, Maddalena; Petraglia, Laura; Poggio, Paolo; Valerio, Vincenza; Cabaro, Serena; Caldarola, Pasquale; Castaldo, Giuseppe; Attena, Emilio; Russo, Vincenzo; Formisano, Pietro; Leosco, Dario; Parisi, Valentina

doi:10.3389/fmed.2022.844266

Cited by 37 publications

(35 citation statements)

References 174 publications

(172 reference statements)

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“…In these conditions, EAT takes a pro-inflammatory, pro-fibrotic and pro-atherosclerotic phenotype and produces and secretes mainly pro-inflammatory cytokines and mediators. In this thicker and dysfunctional EAT, the histological analysis showed an increased inflammatory and immune infiltrate, consisting of T and B lymphocytes, dendritic cells, eosinophils and macrophages, and a cellular polarization characterized by a prevalence of proinflammatory macrophages M1 ( 62 , 63 ). The role of structural and functional changes of EAT in the pathogenesis of various cardiovascular diseases has been explored and confirmed by several studies ( 54 , 56 , 57 , 64 ).…”

Section: Epicardial Adipose Tissue: Pathophysiology and Clinical Asse...mentioning

confidence: 80%

Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation

Conte

Petraglia²,

Cabaro³

et al. 2022

Front. Cardiovasc. Med.

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Atrial Fibrillation (AF) is the most frequent cardiac arrhythmia and its prevalence increases with age. AF is strongly associated with an increased risk of stroke, heart failure and cardiovascular mortality. Among the risk factors associated with AF onset and severity, obesity and inflammation play a prominent role. Numerous recent evidence suggested a role of epicardial adipose tissue (EAT), the visceral fat depot of the heart, in the development of AF. Several potential arrhythmogenic mechanisms have been attributed to EAT, including myocardial inflammation, fibrosis, oxidative stress, and fat infiltration. EAT is a local source of inflammatory mediators which potentially contribute to atrial collagen deposition and fibrosis, the anatomical substrate for AF. Moreover, the close proximity between EAT and myocardium allows the EAT to penetrate and generate atrial myocardium fat infiltrates that can alter atrial electrophysiological properties. These observations support the hypothesis of a strong implication of EAT in structural and electrical atrial remodeling, which underlies AF onset and burden. The measure of EAT, through different imaging methods, such as echocardiography, computed tomography and cardiac magnetic resonance, has been proposed as a useful prognostic tool to predict the presence, severity and recurrence of AF. Furthermore, EAT is increasingly emerging as a promising potential therapeutic target. This review aims to summarize the recent evidence exploring the potential role of EAT in the pathogenesis of AF, the main mechanisms by which EAT can promote structural and electrical atrial remodeling and the potential therapeutic strategies targeting the cardiac visceral fat.

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Section: Epicardial Adipose Tissue: Pathophysiology and Clinical Asse...mentioning

confidence: 80%

Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation

Conte

Petraglia²,

Cabaro³

et al. 2022

Front. Cardiovasc. Med.

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“…The absence of CLS in the VR group could be explained by the small adipocytes size difference (about 10%), but mainly by the different ages of the two study groups, as the CABG group was more than 10 years older than the VR group, who did not show any sign of CAD in the pre-operative coronary angiographic examination. Aging has been recently reported as an important factor worsening EAT chronic inflammation [15].…”

Section: Resultsmentioning

confidence: 99%

The density of crown-like structures in epicardial adipose tissue could play a role in cardiovascular diseases

et al. 2022

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Purpose The visceral fat of patients affected by abdominal obesity is inflamed, and the main histopathologic feature is the high density of crown-like structures (CLS). Epicardial adipose tissue (EAT) is a visceral fat of paramount importance for its relationships with coronary vessels and myocardium. Its inflammation in patients with abdominal obesity could be of clinical relevance, but histopathological studies on CLS density in EAT are lacking. This study aimed to assess the histopathology of EAT biopsies obtained from patients undergoing open-heart surgery. Methods We collected EAT biopsies from 10 patients undergoing open-heart surgery for elective coronary artery bypass grafting (CABG) (n = 5) or valvular replacement (VR) (n = 5). Biopsies were treated for light microscopy and immunohistochemistry. We quantify the CLS density in each EAT sample. Results Despite all patients having abdominal obesity, in EAT samples, no CLS were detected in the VR group; in contrast, CLS were detected in the CABG group (about 17 CLS/10 4 adipocytes vs. 0.0 CLS/10 4 adipocytes, CABG vs. VR group, respectively). An impressive density of CLS (100 times that of other patients) was found in one patient (LS) in the CABG group that had a relevant anamnestic aspect: relatively rapid increase of weight gain, especially in abdominal adipose tissue, coincident with myocardial infarction. Conclusions CLS density could be an important predictive tool for cardiovascular diseases. Furthermore, the LS case implies a role for timing in weight gain. Level of evidence No level of evidence; this is a basic science study.

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“…In line with these data, we recently showed that whitening of brown fat induces a high degree of in ammation with a high density of CLS in this depot (12) The absence of CLS in the VR group could be explained by the small adipocytes size difference (about 10%), but mainly by the different ages of the two study groups, as the CABG group was more than ten years older than the VR group, who did not show any sign of CAD in the pre-operative coronary angiographic examination. Aging has been recently reported as an important factor worsening EAT chronic in ammation (13).…”

Section: Resultsmentioning

confidence: 99%

The density of Crown-Like Structures in epicardial adipose tissue could play a role in cardiovascular diseases

Malavazos

Vincenzo

Iacobellis

et al. 2022

Preprint

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Purpose The visceral fat of patients affected by abdominal obesity is inflamed, and the main histopathologic feature is the high density of crown-like structures (CLS). Epicardial adipose tissue (EAT) is a visceral fat of paramount importance for its relationships with coronary vessels and myocardium. Its inflammation in patients with abdominal obesity could be of clinical relevance, but histopathological studies on CLS density in EAT are lacking. This study aimed to assess the histopathology of EAT biopsies obtained from patients undergoing open-heart surgery. Methods We collected EAT biopsies from 10 patients undergoing open-heart surgery for elective coronary artery bypass grafting (CABG) (n=5) or valvular replacement (VR) (n=5). Biopsies were treated for light microscopy and immunohistochemistry. We quantify the CLS density in each EAT sample. Results Despite all patients having abdominal obesity, in EAT samples, no CLS were detected in the VR group; in contrast, CLS were detected in the CABG group (about 17 CLS/104 adipocytes vs. 0,0 CLS/104 adipocytes, CABG vs. VR group, respectively). An impressive density of CLS (100 times that of other patients) was found in one patient (LS) in the CABG group that had a relevant anamnestic aspect: relatively rapid increase of weight gain, especially in abdominal adipose tissue, coincident with myocardial infarction. Conclusion CLS density could be an important predictive tool for cardiovascular diseases. Furthermore, the LS case implies a role for timing in weight gain.Level of evidence: No level of evidence; this is a basic science study.

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Inflammation and Cardiovascular Diseases in the Elderly: The Role of Epicardial Adipose Tissue

Cited by 37 publications

References 174 publications

Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation

Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation

The density of crown-like structures in epicardial adipose tissue could play a role in cardiovascular diseases

The density of Crown-Like Structures in epicardial adipose tissue could play a role in cardiovascular diseases

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