-
Nature Reviews. Cardiology Sep 2022Interest in epicardial adipose tissue (EAT) is growing rapidly, and research in this area appeals to a broad, multidisciplinary audience. EAT is unique in its anatomy... (Review)
Review
Interest in epicardial adipose tissue (EAT) is growing rapidly, and research in this area appeals to a broad, multidisciplinary audience. EAT is unique in its anatomy and unobstructed proximity to the heart and has a transcriptome and secretome very different from that of other fat depots. EAT has physiological and pathological properties that vary depending on its location. It can be highly protective for the adjacent myocardium through dynamic brown fat-like thermogenic function and harmful via paracrine or vasocrine secretion of pro-inflammatory and profibrotic cytokines. EAT is a modifiable risk factor that can be assessed with traditional and novel imaging techniques. Coronary and left atrial EAT are involved in the pathogenesis of coronary artery disease and atrial fibrillation, respectively, and it also contributes to the development and progression of heart failure. In addition, EAT might have a role in coronavirus disease 2019 (COVID-19)-related cardiac syndrome. EAT is a reliable potential therapeutic target for drugs with cardiovascular benefits such as glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter 2 inhibitors. This Review provides a comprehensive and up-to-date overview of the role of EAT in cardiovascular disease and highlights the translational nature of EAT research and its applications in contemporary cardiology.
Topics: Adipose Tissue; Atrial Fibrillation; COVID-19; Cardiology; Humans; Pericardium
PubMed: 35296869
DOI: 10.1038/s41569-022-00679-9 -
Progress in Cardiovascular Diseases 2017Pericardial heart disease includes pericarditis, (an acute, subacute, or chronic fibrinous, noneffusive, or exudative process), and its complications, constriction, (an... (Review)
Review
Pericardial heart disease includes pericarditis, (an acute, subacute, or chronic fibrinous, noneffusive, or exudative process), and its complications, constriction, (an acute, subacute, or chronic adhesive or fibrocalcific response), and cardiac tamponade. The pathophysiology of cardiac tamponade and constrictive pericarditis readily explains their respective findings on clinical examination, Doppler echocardiography, and at cardiac catheterization. The primary abnormality of cardiac tamponade is pan-cyclic compression of the cardiac chambers by increased pericardial fluid requiring that cardiac chambers compete for a fixed intrapericardial volume. Features responsible for the pathophysiology include transmission of thoracic pressure through the pericardium and heightened ventricular interdependence. Constrictive pericarditis is a condition in which the pericardium limits diastolic filling and causes dissociation of intracardiac and intrathoracic pressures, and heightened ventricular interdependence. Both conditions result in diastolic dysfunction, elevated and equal venous and ventricular diastolic pressure, respiratory variation in ventricular filling, and ultimately, reduced cardiac output.
Topics: Cardiac Catheterization; Cardiac Tamponade; Echocardiography, Doppler; Heart Function Tests; Humans; Pericarditis, Constrictive; Pericardium
PubMed: 27916673
DOI: 10.1016/j.pcad.2016.11.001 -
Radiologic Clinics of North America Jan 2019Although the pericardium is simply a 2-layered membrane enveloping the heart and great vessels, there are numerous anatomic variations, congenital anomalies, and... (Review)
Review
Although the pericardium is simply a 2-layered membrane enveloping the heart and great vessels, there are numerous anatomic variations, congenital anomalies, and pathologic conditions that can occur. Although echocardiography is most often the first imaging modality used to assess the pericardium, computed tomography and MR imaging are frequently being used to aid in diagnosis and assess response to therapy. Therefore, detailed knowledge of the pericardium in both its normal and diseased states is important to best direct patient care and potentially improve patient outcomes.
Topics: Contrast Media; Diagnosis, Differential; Heart Neoplasms; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Pericardial Effusion; Pericarditis; Pericardium; Tomography, X-Ray Computed
PubMed: 30454812
DOI: 10.1016/j.rcl.2018.09.001 -
Seminars in Ultrasound, CT, and MR Jun 2016Given the widespread use of cross-sectional imaging modalities, specifically multidetector computed tomography and magnetic resonance, to evaluate thoracic disease, the... (Review)
Review
Given the widespread use of cross-sectional imaging modalities, specifically multidetector computed tomography and magnetic resonance, to evaluate thoracic disease, the pericardium is frequently imaged. Knowledge of the normal appearance and anatomical boundaries is vital for radiologists to avoid confusion with more sinister pathology. A variety of disorders and diseases of the pericardium can bring a patient to clinical attention from inflammatory conditions, resulting in pericarditis and pericardial effusion, to malignancy. This article discusses the anatomy and conditions that affect the pericardium, emphasizing the role imaging plays in diagnosis and management.
Topics: Contrast Media; Diagnostic Imaging; Heart Diseases; Humans; Pericardium
PubMed: 27261348
DOI: 10.1053/j.sult.2015.09.001 -
Progress in Cardiovascular Diseases 2017The normal gross anatomy and light microscopy of the human pericardium are presented in detail that allows easy correlation with current cardiac imaging modalities. The... (Review)
Review
The normal gross anatomy and light microscopy of the human pericardium are presented in detail that allows easy correlation with current cardiac imaging modalities. The anatomical structures of the parietal pericardium are shown from its mediastinal surface, including its ligaments to the sternum, diaphragm and vertebral column. The attachments of the parietal pericardium to the great vessels showing the intrapericardial location of the root of the aorta and pulmonary artery are documented. Also the attachments of the parietal pericardium to the venae cavae and the pulmonary veins are illustrated in detail. The internal anatomy of the parietal pericardium emphasizing the oblique and transverse sinuses is explained. The microscopic differences between the structures of the parietal pericardium and visceral pericardium (epicardium) are shown as the basis that allows understanding the spectrum of adaptation of the pericardium to diverse pathologic processes. However, the pathology of the pericardium is not discussed in this review.
Topics: Diagnostic Techniques, Cardiovascular; Histological Techniques; Humans; Pericardium
PubMed: 28062264
DOI: 10.1016/j.pcad.2016.12.010 -
Cold Spring Harbor Perspectives in... Feb 2020The epicardium, the outermost tissue layer that envelops all vertebrate hearts, plays a crucial role in cardiac development and regeneration and has been implicated in... (Review)
Review
The epicardium, the outermost tissue layer that envelops all vertebrate hearts, plays a crucial role in cardiac development and regeneration and has been implicated in potential strategies for cardiac repair. The heterogenous cell population that composes the epicardium originates primarily from a transient embryonic cell cluster known as the proepicardial organ (PE). Characterized by its high cellular plasticity, the epicardium contributes to both heart development and regeneration in two critical ways: as a source of progenitor cells and as a critical signaling hub. Despite this knowledge, there are many unanswered questions in the field of epicardial biology, the resolution of which will advance the understanding of cardiac development and repair. We review current knowledge in cross-species epicardial involvement, specifically in relation to lineage specification and differentiation during cardiac development.
Topics: Animals; Cell Differentiation; Pericardium; Regeneration; Stem Cells
PubMed: 31451510
DOI: 10.1101/cshperspect.a037192 -
Folia Histochemica Et Cytobiologica 2016Normal pericardium consists of an outer sac called fibrous pericardium and an inner one called serous pericardium. The two layers of serous pericardium: visceral and... (Review)
Review
Normal pericardium consists of an outer sac called fibrous pericardium and an inner one called serous pericardium. The two layers of serous pericardium: visceral and parietal are separated by the pericardial cavity, which contains 20 to 60 mL of the plasma ultrafiltrate. The pericardium acts as mechanical protection for the heart and big vessels, and a lubrication to reduce friction between the heart and the surrounding structures. A very important role in all aspects of pericardial functions is played by mesothelial cells. The mesothelial cells form a monolayer lining the serosal cavity and play an important role in antigen presentation, inflammation and tissue repair, coagulation and fibrinolysis. The two major types of mesothelial cells, flat or cuboid, differ substantially in their ultrastructure and, probably, functions. The latter display abundant microvilli, RER, Golgi dense bodies, membrane-bound vesicles and intracellular vacuoles containing electron-dense material described as dense bodies. The normal structure and functions of the pericardium determine correct healing after its injury as a result of surgery or microbial infection. The unfavorable resolution of acute or chronic pericarditis leads to the formation of adhesions between pericardial leaflets which may lead to serious complications.
Topics: Animals; Heart; Humans; Pericardium
PubMed: 27654013
DOI: 10.5603/FHC.a2016.0014 -
Heart (British Cardiac Society) Aug 2022
Topics: Electrocardiography; Humans; Magnetic Resonance Imaging; Pericarditis; Pericarditis, Constrictive; Pericardium
PubMed: 35580979
DOI: 10.1136/heartjnl-2021-320728 -
Cardiology Clinics Nov 2017The pericardium consists of a visceral mesothelial monolayer (epicardium) that reflects over the great vessels and joins an outer, relatively inelastic fibrous parietal... (Review)
Review
The pericardium consists of a visceral mesothelial monolayer (epicardium) that reflects over the great vessels and joins an outer, relatively inelastic fibrous parietal layer of organized collagen and elastin fibers, between which is a potential space that normally contains up to 50 mL of plasma filtrate. Although not essential for life, the pericardium serves important albeit subtle functions in the euvolemic healthy individual that become increasingly important in hypervolemic states and conditions in which the heart enlarges acutely. The pericardial functions can be divided into the mechanical, reflex, membranous, metabolic, ligamentous.
Topics: Elastin; Epithelium; Hemodynamics; Humans; Pericardium; Prostaglandins I; Ventricular Function
PubMed: 29025540
DOI: 10.1016/j.ccl.2017.07.002 -
Cardiology 2024
Topics: Humans; Heart Failure; Pericardium
PubMed: 38246145
DOI: 10.1159/000536356