心外膜脂肪组织与心房颤动的分子机制研究进展

Research Progress on Molecular Mechanism of Epicardial Adipose Tissue and Atrial Fibrillation

心房颤动(atrial fibrillation,AF)是临床上常见的心律失常,与心血管疾病的发病率和死亡率增加相关.心外膜脂肪组织(epicardial adipose tissue,EAT)是具有重要内分泌功能的生物活性器官.近年来已有大量的研究显示EAT的体积、厚度与AF的发生、严重程度及复发相关,但EAT在AF发病机理中的确切作用尚需进一步阐明,为通过干预EAT来治疗AF提供新思路.

Atrial fibrillation(AF)is the most common arrhythmia in clinical practice and is associated with increased cardiovascular morbidity and mortality.Recently,rather than general fat distribution,epicardial adipose tissue(EAT)gains a growing concern.EAT is the local adipose deposition between myocardium and pericardium.Accumulated evidence revealed several distinguishing characteristics of EAT.It lies contiguously with the myocardium and could infiltrate into myocardium,actively secrets cytokines and adipokines mediating inflammation or remodeling,and contains abundant ganglionated plexi.It is suggested that EAT is associated with the initiation,perpetuation and recurrence of AF,but the precise role of EAT in AF pathogenesis is not completely elucidated.Mechanisms involve adipocyte infiltration,profibrotic and pro-inflammatory paracrine effects,oxidative stress,neural mechanisms and genetic factors.This article reviews the characteristics of EAT,the relationship between imaging parameters and AF,the latest progress of molecular mechanism and treatment strategy in the occurrence and development of AF.