Targeting perivascular and epicardial adipose tissue inflammation: therapeutic opportunities for cardiovascular disease

Clin Sci (Lond). 2020 Apr 17;134(7):827-851. doi: 10.1042/CS20190227.

Abstract

Major shifts in human lifestyle and dietary habits toward sedentary behavior and refined food intake triggered steep increase in the incidence of metabolic disorders including obesity and Type 2 diabetes. Patients with metabolic disease are at a high risk of cardiovascular complications ranging from microvascular dysfunction to cardiometabolic syndromes including heart failure. Despite significant advances in the standards of care for obese and diabetic patients, current therapeutic approaches are not always successful in averting the accompanying cardiovascular deterioration. There is a strong relationship between adipose inflammation seen in metabolic disorders and detrimental changes in cardiovascular structure and function. The particular importance of epicardial and perivascular adipose pools emerged as main modulators of the physiology or pathology of heart and blood vessels. Here, we review the peculiarities of these two fat depots in terms of their origin, function, and pathological changes during metabolic deterioration. We highlight the rationale for pharmacological targeting of the perivascular and epicardial adipose tissue or associated signaling pathways as potential disease modifying approaches in cardiometabolic syndromes.

Keywords: Epicardial Adipose; Heart failure; Perivascular Adipose; Vascular dysfunction; diabetes; obesity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adipogenesis / drug effects
  • Adipokines / antagonists & inhibitors*
  • Adipokines / metabolism
  • Adipose Tissue / drug effects*
  • Adipose Tissue / metabolism
  • Adipose Tissue / pathology
  • Adipose Tissue / physiopathology
  • Adiposity / drug effects
  • Animals
  • Anti-Inflammatory Agents / therapeutic use*
  • Blood Vessels / drug effects*
  • Blood Vessels / metabolism
  • Blood Vessels / pathology
  • Blood Vessels / physiopathology
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / pathology
  • Cardiovascular Diseases / physiopathology
  • Energy Metabolism / drug effects
  • Humans
  • Inflammation / drug therapy*
  • Inflammation / metabolism
  • Inflammation / pathology
  • Inflammation / physiopathology
  • Inflammation Mediators / antagonists & inhibitors*
  • Inflammation Mediators / metabolism
  • Molecular Targeted Therapy
  • Pericardium / drug effects*
  • Pericardium / metabolism
  • Pericardium / pathology
  • Pericardium / physiopathology
  • Signal Transduction

Substances

  • Adipokines
  • Anti-Inflammatory Agents
  • Inflammation Mediators

Grants and funding