Cardiac Sympathetic Denervation in the Failing Heart

White, Ian

doi:10.1161/circresaha.116.308621

Cited by 12 publications

(9 citation statements)

References 26 publications

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“…EAT can also be involved in the pathogenesis of heart failure through neurohormonal mechanisms via the intrinsic adrenergic and cholinergic nerves, which interact with the extrinsic cardiac sympathetic and parasympathetic nervous systems 113 – 115 . EAT is, therefore, an important source of catecholamines, both noradrenaline and adrenaline 116 .…”

Section: Role Of Eat In Cardiovascular Diseasementioning

confidence: 99%

Epicardial adipose tissue in contemporary cardiology

2022

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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.

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Section: Role Of Eat In Cardiovascular Diseasementioning

confidence: 99%

Epicardial adipose tissue in contemporary cardiology

2022

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“…These EAT nerves represent a significant source of norepinephrine and epinephrine. White (30) reported that an increase in EAT volume correlates with a hyperactive adrenergic signaling resulting from an increased catecholamine biosynthesis. EAT thickness is also associated with higher levels of inflammatory cytokines, and a higher inflammatory state can subsequently lead to a higher structural and electrical remodeling of the heart and finally a higher incidence of arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Effect of Echocardiographic Epicardial Adipose Tissue Thickness on Success Rates of Premature Ventricular Contraction Ablation

et al. 2019

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Background:Idiopathic premature ventricular contractions are frequently detected ventricular arrhythmias, and radiofrequency ablation is an effectively treatment for improving symptoms and eliminating premature ventricular contractions. Studies have reported a relationship between an elevated epicardial adipose tissue thickness and myocardial structural pathologies. However, the association between epicardial adipose tissue thickness and success rates of premature ventricular contraction ablation has not yet been investigated.Aims:To assess the relationship between epicardial adipose tissue thickness and success rates of premature ventricular contraction ablation.Study Design:Retrospective case-control study.Methods:This study enrolled a total of 106 consecutive patients who have had a high premature ventricular contraction burden of >10,000/24-h assessed using ambulatory Holter monitorization and underwent catheter ablation. A frequency of premature ventricular contractions of more than 10,000/day was defined as frequent premature ventricular contraction. Epicardial adipose tissue thickness was measured using 2D transthoracic echocardiography. A successful ablation was defined as >80% decrease in pre-procedural premature ventricular contraction attacks with the same morphology during 24-h Holter monitorization after a 1-month follow-up visit from an ablation procedure.Results:Successful premature ventricular contraction ablation was achieved in 87 (82.1%) patients. Epicardial adipose tissue thickness was significantly higher in patients with unsuccessful ablation (p<0.001). Procedure time, total fluoroscopy time, and radiofrequency ablation time were statistically higher in the unsuccessful group (p<0.001). Stepwise multivariate logistic regression analysis showed that epicardial adipose tissue thickness and pseudo-delta wave time were independently associated with procedural success (both p values <0.001). In the receiver-operating curve analysis, epicardial adipose tissue thickness was found to be an important predictor for procedural success (area under the receiver-operating characteristic curve= 0.85, p=0.001), with a cutoff value of 7.7 mm, a sensitivity of 92%, and a specificity of 68%.Conclusion:Epicardial adipose tissue thickness is higher in patients with premature ventricular contraction ablation failure, which may be indicative of procedural success.

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“…Finally, an Italian study in systolic heart failure patients identified a highly significant correlation between EAT thickness and the extent of cardiac sympathetic denervation [ 65 ]. Specifically, EAT thickness was reported to be useful as an independent predictor of SNS dysfunction, since left ventricular mass, EAT thickness, and cardiac sympathetic denervation were found to correlate well with one another in systolic heart failure patients [ 66 ].…”

Section: Autonomic Dysregulation and Eat: Implications For Human Afib...mentioning

confidence: 99%

“…Although the reported elevations in expression of these enzymes were astonishingly huge (~8-fold for the mRNAs and ~15-fold (!) for the proteins), raising concerns about the accuracy of the reported values, this study clearly identified human EAT as a significant source of both NE and Epi, at least in the context of systolic heart failure, which might contribute to the well-documented SNS hyperactivity that accompanies and aggravates human heart failure [ 65 , 66 ]. The increased catecholamine biosynthetic activity of EAT in systolic heart failure, which is obviously the result of a thickened EAT (higher volume EAT contains more adipocytes synthesizing more catecholamines), adds to the total catecholamine accumulation in the failing heart’s EAT [ 65 ].…”

Section: Autonomic Dysregulation and Eat: Implications For Human Afib...mentioning

confidence: 99%

Autonomic Nervous System Regulation of Epicardial Adipose Tissue: Potential Roles for Regulator of G Protein Signaling-4

Carbone

Calvo

Nagliya

et al. 2022

CIMB

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The epicardial adipose tissue (EAT) or epicardial fat is a visceral fat depot in the heart that contains intrinsic adrenergic and cholinergic nerves, through which it interacts with the cardiac sympathetic (adrenergic) and parasympathetic (cholinergic) nervous systems. These EAT nerves represent a significant source of several adipokines and other bioactive molecules, including norepinephrine, epinephrine, and free fatty acids. The production of these molecules is biologically relevant for the heart, since abnormalities in EAT secretion are implicated in the development of pathological conditions, including coronary atherosclerosis, atrial fibrillation, and heart failure. Sympathetic hyperactivity and parasympathetic (cholinergic) derangement are associated with EAT dysfunction, leading to a variety of adverse cardiac conditions, such as heart failure, diastolic dysfunction, atrial fibrillation, etc.; therefore, several studies have focused on exploring the autonomic regulation of EAT as it pertains to heart disease pathogenesis and progression. In addition, Regulator of G protein Signaling (RGS)-4 is a protein with significant regulatory roles in both adrenergic and muscarinic receptor signaling in the heart. In this review, we provide an overview of the autonomic regulation of EAT, with a specific focus on cardiac RGS4 and the potential roles this protein plays in this regulation.

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Cardiac Sympathetic Denervation in the Failing Heart

Cited by 12 publications

References 26 publications

Epicardial adipose tissue in contemporary cardiology

Epicardial adipose tissue in contemporary cardiology

Effect of Echocardiographic Epicardial Adipose Tissue Thickness on Success Rates of Premature Ventricular Contraction Ablation

Autonomic Nervous System Regulation of Epicardial Adipose Tissue: Potential Roles for Regulator of G Protein Signaling-4

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