Epicardial adipose tissue in obesity with heart failure with preserved ejection fraction: Cardiovascular magnetic resonance biomarker study

BACKGROUND Obesity has become a serious public health issue,significantly elevating the risk of various complications.It is a well-established contributor to Heart failure with preserved ejection fraction(HFpEF).Evaluating HFpEF in obesity is crucial.Epicardial adipose tissue(EAT)has emerged as a valuable tool for validating prognostic biomarkers and guiding treatment targets.Hence,assessing EAT is of paramount importance.Cardiovascular magnetic resonance(CMR)imaging is acknowledged as the gold standard for analyzing cardiac function and mor-phology.We hope to use CMR to assess EAT as a bioimaging marker to evaluate HFpEF in obese patients.AIM To assess the diagnostic utility of CMR for evaluating heart failure with preserved ejection fraction[HFpEF;left ventricular(LV)ejection fraction≥50%]by measuring the epicardial adipose tissue(EAT)volumes and EAT mass in obese patients.METHODS Sixty-two obese patients were divided into two groups for a case-control study based on whether or not they had heart failure with HFpEF.The two groups were defined as HFpEF+and HFpEF-.LV geometry,global systolic function,EAT volumes and EAT mass of all subjects were obtained using cine magnetic resonance sequences.RESULTS Forty-five patients of HFpEF-group and seventeen patients of HFpEF+group were included.LV mass index(g/m2)of HFpEF+group was higher than HFpEF-group(P<0.05).In HFpEF+group,EAT volumes,EAT volume index,EAT mass,EAT mass index and the ratio of EAT/[left atrial(LA)left-right(LR)diameter]were higher compared to HFpEF-group(P<0.05).In multivariate analysis,Higher EAT/LA LR diameter ratio was associated with higher odds ratio of HFpEF.CONCLUSION EAT/LA LR diameter ratio is highly associated with HFpEF in obese patients.It is plausible that there may be utility in CMR for assessing obese patients for HFpEF using EAT/LA LR diameter ratio as a diagnostic biomarker.Further prospective studies,are needed to validate these proof-of-concept findings.

From the epicardial adipose tissue to vulnerable coronary plaques

Thin cap fibroatheromas(TCFAs) are thought to be the most common underlying substrate in patients suffering acute coronary thrombotic events.Recently,an interesting association between TCFAs and a particular depot of visceral fat called epicardial adipose tissue(EAT) has been suggested.In this article,we discuss some basic and clinical aspects of this association and then briefly review some of the pathophysiological characteristics attributed to EAT that explain why this particular depot of fat has been attracting the attention of the cardiological scientific community in recent years.Finally we discuss the value of optical coherence tomography in the diagnosis of TCFAs and the role of multislice computed tomography to assess EAT.

Influence of increased epicardial adipose tissue volume on 1-year in-stent restenosis in patients who received coronary stent implantation

Background Epicardial adipose tissue （EAT） is significantly associated with the formation and composition of coronary atherosclerotic plaque, cardiac events and the clinical prognosis of coronary heart disease. But, whether increased EAT deposition may affect the incidence of in-stent restenosis （ISR） is currently unclear. This study used coronary computed tomography angiography （CCTA） as a mean to investigate whether increased EAT volume was associated with ISR. Methods A total of 364 patients who underwent 64-slice CCTA examination for the evaluation of suspected coronary artery disease, and subsequently underwent percutaneous coronary intervention （PCI） for the first time, and then accepted coronary angiography （CA） follow-up for ISR examination in one year, were retrospectively included in this study. EAT volume was measured by CCTA examination. CA follow-up was obtained between 9 and 15 months. ISR was defined as 〉 50% kuninal diameter narrowing of the stent segment or peri-stent segment. EAT volume was compared between patients with and without ISR and additional well-known predictors of ISR were compared. Results EAT volume was significantly increased in patients with ISR compared with those without ISR （154.5 ± 74.6 mL vs. 131.0 ± 52.2 mL, P 〈 0.001）. The relation between ISR and EAT volume remained significant after adjustment for conventional cardiovascular risk factors and angiographic parameters. Conclusions EAT volume was related with ISR and may provide additional information for future ISR.

Roles of Human Epicardial Adipose Tissue in Coronary Artery Atherosclerosis

This study examined the adipocytokine-vascular interactions and link between epicardial adipose tissue and coronary artery atherosclerosis.Thirty-four patients undergoing open heart surgery were chosen randomly, and divided into groupⅠ(non-coronary artery disease group) and group Ⅱ(coronary artery disease group).Blood samples were taken through peripheral vein prior to surgery.Plasma levels of a panel of proteins (adiponectin, IL-10, TNF-α) were detected by using ELISA.Epicardial adipose tissue was taken near the proximal tract of the right coronary artery and subcutaneous adipose was taken from the leg before cardiopulmonary bypassing, adiponectin and CD68+ were detected by using RT-PCR and immunohistochemistry.Our results showed that plasma adiponectin level was significantly lower in the group Ⅱ as compared with group Ⅰ(P【0.05).There were no differences in plasma concentration (IL-10, TNF-α, tatal-chol, HDL-chol, LDL-chol) between group Ⅰ and group Ⅱ.The number of CD68+ cells in epicardial adipose tissue of group Ⅱ was significantly higher than that in subcutaneous adipose tissue.Adiponectin mRNA expression was 6 fold higher in subcutaneous adipose tissue than in epicardial adipose tissue of group Ⅱ (P【0.01).Furthermore, the level of adiponectin mRNA in the epicardial adipose tissue in group Ⅱ was also significantly lower than in group Ⅰ (P【0.05).We are led to conclude that inflammation that occurs locally in epicardial adipose tissue of CAD contributes to the pathogenesis of coronary artery disease.

Relation between Epicardial Adipose Tissue Thickness Assessed by Multidetector Computed Tomography and Significance of Coronary Artery Disease

Objective: To evaluate the relation between epicardial adipose tissue (EAT) thickness and also pericoronary fat assessed by Multidetector Computed Tomography (MDCT) with both calcium score and significance of coronary artery disease. Background: Epicardial adipose tissue (the visceral fat of the heart present under the visceral layer of the pericardium) has the same origin of abdominal visceral fat, which is known to be strongly related to the development of coronary artery atherosclerosis. Multidetector CT (MDCT) provides an accurate and reproducible quantification of EAT due to its high spatial and temporal resolution. Patients and Methods: The current study included 70 patients with low-intermediate probability of coronary artery disease. All patients were subjected to 256 Multidetectors CT to assess EAT thickness, the mean thickness of the pericoronary fat surrounding the three coronary arteries and coronary calcium score. Also coronary CT angiography was done and patients were then divided into 3 groups according to significance of coronary atherosclerosis: Group 1: No atherosclerosis (20 patients), Group 2: Non obstructive atherosclerosis (luminal narrowing less than 50% in diameter) (25 patients), Group3: Obstructive atherosclerosis (luminal narrowing ≥ 50%) (25 patients). Results: The mean EAT thickness and the mean pericoronary fat thickness were significantly higher in patients with obstructive coronary artery disease (CAD) with stenosis > 50% (group 3) compared to other groups with normal coronaries or non obstructive (CAD). ROC curve was used to define the best cut off value of the thickness of both EAT and pericoronary fat in predicting the obstructive CAD group which was ≥7.2 and 12.6 mm for epicardial and pericoronary fat respectively. Also there is a positive correlation between both epicardial adipose tissue and pericoronary fat thickness and the coronary calcium score. Conclusion: EAT thickness and pericoronary fat thickness can be used in predicting the significance of coronary artery disease.

Targeting epicardial adipose tissue:A potential therapeutic strategy for heart failure with preserved ejection fraction with type 2 diabetes mellitus

Heart failure with preserved ejection fraction(HFpEF)is a heterogeneous syndrome with various comorbidities,multiple cardiac and extracardiac pathophysiologic abnormalities,and diverse phenotypic presentations.Since HFpEF is a heterogeneous disease with different phenotypes,individualized treatment is required.HFpEF with type 2 diabetes mellitus(T2DM)represents a specific phenotype of HFpEF,with about 45%-50% of HFpEF patients suffering from T2DM.Systemic inflammation associated with dysregulated glucose metabolism is a critical pathological mechanism of HFpEF with T2DM,which is intimately related to the expansion and dysfunction(inflammation and hypermetabolic activity)of epicardial adipose tissue(EAT).EAT is well established as a very active endocrine organ that can regulate the pathophysiological processes of HFpEF with T2DM through the paracrine and endocrine mechanisms.Therefore,suppressing abnormal EAT expansion may be a promising therapeutic strategy for HFpEF with T2DM.Although there is no treatment specifically for EAT,lifestyle management,bariatric surgery,and some pharmaceutical interventions(anti-cytokine drugs,statins,proprotein convertase subtilisin/kexin type 9 inhibitors,metformin,glucagon-like peptide-1 receptor agonists,and especially sodium-glucose cotransporter-2 inhibitors)have been shown to attenuate the inflammatory response or expansion of EAT.Importantly,these treatments may be beneficial in improving the clinical symptoms or prognosis of patients with HFpEF.Accordingly,well-designed randomized controlled trials are needed to validate the efficacy of current therapies.In addition,more novel and effective therapies targeting EAT are needed in the future.

Epicardial adipose tissue deposition in patients with diabetes and renal impairment: Analysis of the literature

Diabetes mellitus(DM)is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates.Renal disease in patients with diabetes is associated with increased morbidity and premature mortality,particularly attributed to their very high cardiovascular risk.Since this group of patients frequently lacks specific symptomatology prior to the adverse events,a screening tool for the identification of high-risk patients is necessary.The epicardial adipose tissue(EAT)is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease.Superior to conventional cardiovascular risk factors and anthropometric measures,including body mass index and waist circumference,the EAT can early predict the development of coronary artery disease.Assessment of EAT can be performed by twodimensional echocardiography,magnetic resonance imaging or computer tomography.However,its role and significance in patients with DM and nephropathy has not been thoroughly evaluated.The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment.Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements,uncontrolled underlying disease,high body mass index and raised cardiovascular risk markers.Acknowledging the practical implications of this test,EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.

Cardiovascular Risk Factors and Epicardial Adipose Tissue Measured by Chest Computed Tomography in Healthy Adults

Background: Epicardial adipose tissue (EAT) may produce several cytokines contributed to coronary atherosclerosis. EAT was measured by transthoracic echocardiography or 3 dimensional cardiac computed tomography (CT) on previous studies. We aimed to evaluate the correlation between EAT thickness and cardiovascular risk factors in healthy adults. Method: We collected clinical, biochemical information from 469 subjects (371 men and 98 women) who visited our health promotion center. EAT thickness was measured by chest CT on the free wall of the right ventricle. Result: The mean EAT thickness was 2.47 ± 1.64 mm in total of 469 subjects. EAT thickness was significantly correlated to age, weight, body mass index (BMI), total body fat, systolic and diastolic blood pressure, total cholesterol, low density lipoprotein (LDL)-cholesterol, and fasting glucose in men and to age, height, weight, BMI, total body fat, systolic and diastolic blood pressure, triglycerides, C-reactive protein (CRP), and fasting glucose in women. Multivariate analysis showed that age, BMI, systolic blood pressure, fasting glucose were the variables that independently correlated to EAT thickness in men. But there was no significant independent variable in women. Conclusion: In our study, EAT thickness measured with chest CT in healthy individuals correlates with cardiovascular risk factors in men.

Epicardial adipose tissue around the superior vena cava: A single center study of factors related to atrial fibrillation

The superior vena cava(SVC)is the main component of non-pulmonary vein(PV)ectopy in patients with atrial fibrillation(AF).Researchers have found that epicardial adipose tissue(EAT)volume is related to the AF substrate,which can be defined by the low voltage area(LVA).This study aimed to investigate the relationship between SVC-EAT and SVC-AF.Twenty-six patients with SVC-AF triggers were identified as the SVC-AF group.Other three groups were defined and included as the LVA-AF group(LVA>5%),non-LVA-AF group(LVA<5%),and physical examination(PE)group.EAT around left atrium(LA-EAT)and SVC-EAT volumes were obtained using a cardiac risk assessment module.According to the SVC/LA-EAT ratio,there are significant differences between the SVC-AF group and the three control groups(the SVC-AF group 0.092±0.041 vs.the LVA-AF group 0.054±0.026,the non-LVA-AF group 0.052±0.022,and the PE group 0.052±0.019,all P<0.001).Receiver operating characteristic curve analysis suggests the optimal cut-off point of SVC/LA-EAT ratio is 6.8%for detecting SVC-AF patients,with 81.1%sensitivity,73.1%specificity,and an area under the curve of 0.83(95%confidence interval,0.75-0.91).Those with SVC-AF have a higher SVC/LA-EAT ratio and empirical SVC isolation could be considered if the SVC/LA-EAT ratio was over 6.8%.

Epicardial Adipose Tissue in Patients with Obstructive Sleep Apnea:A Systematic Review and Meta-analysis

Objective:Epicardial adipose tissue(EAT)is a potential risk factor for obstructive sleep apnea(OSA).We performed a meta-analysis to assess the association of EAT with OSA.Methods:The PubMed,EMBASE,Web of Science,Cochrane Library,and Wanfang databases were searched by two independent investigators for all observational studies assessing the association of EAT with OSA.Then we assessed the association of EAT thickness(EAT-t)and EAT volume(EAT-v)with OSA by a meta-analysis.Results:Ten studies were included in the fi nal analysis.Compared with that in controls,EAT-t in OSA patients was signifi cantly increased(standardized mean difference 0.88,95%confi dence interval 0.72-1.05,P=0.000).Furthermore,EAT-t was greater in OSA patients than in controls with similar BMIs.However,we did not fi nd signifi cant differences in EAT-v between OSA patients and controls(standardized mean difference 2.46,95%confi dence interval−0.36 to 5.29,P=0.088).EAT-t in the mild,moderate,and severe OSA subgroups was greater than in the controls.In addition,there were signifi cant differences in EAT-t among the mild,moderate,and severe OSA subgroups.Conclusions:EAT-t was greater in patients with OSA than in controls,and EAT-t was also associated with the severity of OSA.These fi ndings may provide a new clue for the pathogenesis and treatment of OSA.

Role of Epicardial Adipose Tissue in Triggering and Maintaining Atrial Fibrillation

Atrial fibrillation is the most common arrhythmia leading to cardiogenic stroke.Without membranous sructure between epicardial adipose tissue and atrial myocardium,epicardial adipose tissue directly covers the surface of the atrial myocardium.The formation of an epicardial adipose tissue inflammatory microenvironment,fibrosis,infiltration by epicardial adipose tissue,autonomic dysfunction and oxidative stress are important mechanisms that trigger and maintain atrial fibrillation.Those mechanisms are reviewed herein.

Cardiac adipose tissue and its relationship to diabetes mellitus and cardiovascular disease

Type-2 diabetes mellitus(T2DM) plays a central role in the development of cardiovascular disease(CVD). However, its relationship to epicardial adipose tissue(EAT) and pericardial adipose tissue(PAT) in particular is important in the pathophysiology of coronary artery disease. Owing to its close proximity to the heart and coronary vasculature, EAT exerts a direct metabolic impact by secreting proinflammatory adipokines and free fatty acids, which promote CVD locally. In this review, we have discussed the relationship between T2 DM and cardiac fat deposits, particularly EAT and PAT, which together exert a big impact on the cardiovascular health.

Effects of antidiabetic drugs on epicardial fat

Epicardial adipose tissue is defined as a deposit of adipocytes with pathophysiological properties similar to those of visceral fat, located in the space between the myocardial muscle and the pericardial sac. When compared with subcutaneous adipose tissue, visceral adipocytes show higher metabolic activity, lipolysis rates, increased insulin resistance along with more steroid hormone receptors. The epicardial adipose tissue interacts with numerous cardiovascular pathways via vasocrine and paracrine signalling comprised of pro-and anti-inflammatory cytokines excretion. Both the physiological differences be-tween the two tissue types, as well as the fact that fat distribution and phenotype, rather than quantity, affect cardiovascular function and metabolic processes, establish epicardial fat as a biomarker for cardiovascular and metabolic syndrome. Numerous studies have underlined an association of altered epicardial fat morphology, type 2 diabetes mellitus(T2 DM) and adverse cardiovascular events. In this review, we explore the prospect of using the epicardial adipose tissue as a therapeutic target in T2 DM and describe the underlying mechanisms by which the antidiabetic drugs affect the pathophysiological processes induced from adipose tissue accumulation and possibly allow for more favourable cardiovascular outcomes though epicardial fat manipulation.

Epicardial adipose tissue： the accomplice implicated in the genesis and maintenance of atrial fibrillation

Objective The purpose of this review was to delineate our current knowledge of the close relationship between the abundance of epicardial adipose tissue （EAT） and the risk of all major cardiovascular disease, especially atrial fibrillation （AF）. Data sources The data analyzed in this review were mainly from articles reported in PubMed published from 1972 to 2014. Study selection Original articles and critical reviews relevant to EAT and AF were selected. Results EAT, a particular form of metabolically active visceral fat deposited around the heart, is being regarded as an important independent predictor of cardio-metabolic diseases. EAT is composed of smaller adipocytes than other visceral fat depots and functioned like brown adipose tissue （BAT） to protect adjacent tissues. Improving the understanding of EAT in AF genesis and maintenance may contribute to prevent AF and reduce the complications associated with AF. Conclusion The findings suggest that EAT associates with AF severity and the recurrence of AF after catheter ablation even after adjustment forAF risk factors, but the precise mechanisms are not fully elucidated.

A new look at epicardial adipose tissue from the perspective of Iranian traditional medicine

The fact that distribution of body fat can have a major role in the development of metabolic derangement and cardiovascular diseases is supported by a considerable amount of evidence.Therefore it is no surprise that increased of metabolic syndrome. New evidence describing adipose tissue as an advanced endocrine unit, capable of producing substances with remarkable physiologic impacts, has led to increased research interest in this field. While many fatty tissues are similar in composition, some of them, notably subcutaneous and visceral adipose tissues, possess special properties.

Expression profile of circular RNAs in epicardial adipose tissue in heart failure

Background:Recent studies have reported circular RNA(circRNA)expression profiles in various tissue types;however,circRNA expression profile in human epicardial adipose tissue(EAT)remains undefined.This work aimed to compare circRNA expression patterns in EAT between the heart failure(HF)and non-HF groups.Methods:RNA-sequencing was carried out to compare circRNA expression patterns in EAT specimens from coronary artery disease cases between the HF and non-HF groups.Quantitative real-time polymerase chain reaction was performed for validation.Comparisons of patient characteristics between the two groups were using t test,Mann-Whitney U test,and Chi-squared test.Results:A total of 141 circRNAs substantially different between the HF and non-HF groups(P<0.05;fold change>2)were detected,including 56 up-regulated and 85 down-regulated.Among them,hsa_circ_0005565 stood out,for it had the highest fold change and was significantly increased in HF patients in quantitative real-time polymerase chain reaction validation.The top highly expressed EAT circRNAs corresponded to genes involved in cell proliferation and inflammatory response,including GSE1,RHOBTB3,HIPK3,UBXN7,PCMTD1,N4BP2L2,CFLAR,EPB41L2,FCHO2,FNDC3B,and SPECC1.The top enriched Gene Ontology term and Kyoto Encyclopedia of Genes and Genomes pathway were positive regulation of metabolic processes and insulin resistance,respectively.Conclusion:These data indicate EAT circRNAs may contribute to the pathogenesis of metabolic disorders causing HF.

Advances in research of epicardial adipose tissue and diastolic heart failure

Background Epicardial adipose tissue(EAT)is a unique visceral adipose tissue that is located between the myocardium and the visceral layer of the pericardium.Physiologically,EAT can produce heat and protect the heart.Under pathological conditions,EAT is involved in the development of diastolic heart failure(DHF)by secreting a variety of pro-inflammatory cytokines.More and more studies have shown that EAT plays an important role in the inflammatory mechanism and myocardial remodeling of DHF.Exercise,weight loss and drug therapy can significantly reduce the thickness/volume of EAT and its functional disorder.In recent years,research on EAT and DHF has made new progress.This article reviewed the mechanism and treatment of EAT in the development of DHF.

EAT、IMA和hs-cTnT与急性冠状动脉综合征病变程度的相关性

目的探讨心外膜脂肪组织(EAT)厚度、血清缺血修饰白蛋白(IMA)和高敏肌钙蛋白T(hs-cTnT)与急性冠状动脉综合征(ACS)的相关性。方法选择2014年9月至2015年11月我院收治的120例ACS患者作为病例组,其中单支病变组、双支病变组和多支病变组各40例。选择同期在我院进行体检的心功能正常健康者120例作为正常对照组,采用超声心动图测定EAT厚度,采用白蛋白-钴离子结合试验法测定血清IMA水平,采用电化学发光免疫分析法测定血清hs-cTnT水平。结果 ACS患者EAT厚度、IMA和hs-cTnT水平及Gensini积分均显著高于正常对照组(P<0.01)。ACS患者单支病变组、双支病变组和多支病变组EAT厚度、IMA和hs-cTnT水平及Gensini积分变化均呈递增趋势,且均高于正常对照组(P<0.01)。ACS患者EAT厚度、IMA和hs-cTnT水平与Gensini积分呈显著正相关(P<0.01)。单支病变组患者IMA水平与Gensini积分具有相关性(P<0.05),EAT厚度和hs-cTnT水平与Gensini积分无显著相关性(P>0.05);双支病变组和多支病变组患者EAT厚度、IMA和hs-cTnT水平与Gensini积分均呈显著正相关(P<0.05或P<0.01)。结论 EAT厚度、IMA和hs-cTnT水平与ACS病变严重程度具有相关性。

高频超声及结合心脏探头测量心外膜脂肪组织(EAT)厚度与冠心病危险因素关系研究

目的:研究高频超声及结合心脏探头测量心外膜脂肪组织(EAT)厚度与冠心病(CHD)危险因素关系。材料与方法:资料随机选择2012年8月-2014年8月本院心内科98例患者为本研究对象,按照冠脉造影检查结果分为两组,将符合冠心病诊断标准76例患者设为研究组,其余22例患者设为对照组,观察并比较两组患者临床基线资料、生活习惯、用药及实验室指标检测情。结果:两组患者临床基线资料、不良生活习惯及用药情况比较,差异均具统计学意义(P<0.05,P<0.01);两组实验室指标即HDL-C、TG比较,未见显著差别(P>0.05),但CHOL、LDL-C及EAT组间比较,差异显著均具统计学意义(P<0.05)。结论:高频超声测量心外膜脂肪组织厚度与冠心病危险因素关系密切,EAT可作为冠心病早期发现的重要预测指标,具有临床实际应用价值。

冠心病EAT中miR-455b-3p调控脂肪细胞分化及炎症因子

目的筛选在冠状动脉粥样硬化性心脏病(CAD)患者和非冠心病(non-CAD)患者心外膜脂肪组织(EAT)中差异性表达的microRNAs(DE-miRNAs),探讨其中miR-455b-3p对脂肪细胞因子APN、Kruppel样因子4(KLF4)、白细胞介素6(IL-6)和单核细胞因子趋化蛋白1(MCP-1)分泌及对脂肪细胞分化的影响。方法收集冠心病(CAD)34例和非冠心病(non-CAD)16例EAT和血液标本,分别为实验组(CAD组)和对照组(Non-CAD组),采用miRNA芯片技术筛选出EAT中DE-miRNAs,采用实时荧光定量PCR(qRT-PCR)检测标本中miR-455b-3p的表达水平。分别将miR-455b-3p的mimics、miR-455b-3p的inhibitors和NC转染入前体3T3-L1细胞及已诱导成熟的3T3-L1细胞,分为上调组、下调组和NC组。采用qRT-PCR法检测转染24 h后细胞中APN、KLF4、IL-6、MCP-1 mRNA及脂肪细胞分化标志物过氧化物酶体增殖物激活受体-γ(PPARγ)、CCAAT/增强子结合蛋白α(C/EBPα)、脂肪酸结合蛋白4(FABP4)mRNA的相对表达水平。结果与实验组比较,对照组EAT标本中共筛选出29个DE-miRNAs(P<0.05;差异倍数>2,差异有统计学意义),其中下调10个,上调19个。miR-455b-3p是与ADIPOQ 3’-UTR有互补结合位点或密切相关的1条DE-miRNA。qRT-PCR验证结果显示,与对照组比较,miR-455b-3p在实验组中的表达均升高。与NC组比较,转染miR-455b-3p的mimics后,上调组成熟3T3-L1脂肪细胞中APN、KLF4 mRNA表达减少,IL-6、MCP-1 mRNA表达增多;脂肪细胞分化标志物PPARγ、C/EBPα、FABP4 mRNA表达升高;转染miR-455b-3p inhibitor后,下调组APN、KLF4 mRNA表达水平升高,IL-6、MCP-1 mRNA表达减少。结论在CAD组患者EAT中存在差异性表达的miRNAs,其中miR-455b-3p高表达,miR-455b-3p影响脂肪细胞因子APN、KLF4、IL-6以及MCP-1的表达,并且促进脂肪细胞分化成熟,从而影响冠心病的发生发展。