Potential Mechanisms of Epicardial Adipose Tissue Influencing HeartFailure with Preserved Ejection Fraction

Abstract

Heart failure (HF) is the predominant terminal stage and the leading cause ofmortality in cardiac disease. Heart failure with preserved ejection fraction(HFpEF) affects roughly 50% of HF patients globally. Due to the global agingpopulation, the prevalence, morbidity, and mortality of HFpEF have graduallyincreased. Epicardial adipose tissue (EAT), as a key visceral adipose tissuearound the heart, affects cardiac diastolic function and exercise reservecapacity. EAT closely adheres to the myocardium and can produce inflammatoryfactors, neurotransmitters, and other factors through autocrine or paracrinemechanisms, affecting the heart function by inflammatory response, cardiacmetabolism and energy supply, cardiomyocyte structure and electrical activity,and pericardial vascular function. Currently, research on the mechanism andtreatment methods of HFpEF is constantly improving. EAT may play a multi-levelimpact on the occurrence and development of HFpEF. This review also summarizesthe potential impact of EAT on the heart in HFpEF combined with othermetabolism-related diseases such as obesity or diabetes over otherobesity-related measures, such as body mass index (BMI) or other adipose tissue.Above all, this review comprehensively summarizes the potential mechanisms bywhich EAT may affect HFpEF. The objective is to enhance our comprehension andmanagement of HFpEF. Future research should delve into the mechanisticrelationship between EAT and HFpEF, and investigate interventions aimed at EAT toimprove the prognosis of patients with HFpEF.

Keywords

• hf
• hfpef
• epicardial adipose tissue
• visceral adipose tissue