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The Pathophysiology of Heart Failure with Preserved Ejection Fraction
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Vishal N. Rao, Kishan S. Parikh
Regional adiposity can be characterized by fat accumulation in different body areas. Visceral adipose tissue (VAT) refers to the intra-abdominal adipose accumulation of fat, whereas subcutaneous adipose tissue (SAT) refers to fat outside the abdominal cavity and intramuscular space.78 Epicardial adipose tissue (EAT) is fat that surrounds the heart. VAT and EAT exhibit detrimental functions on the heart, including pro-inflammatory and cardiomechanical effects that together worsen diastolic dysfunction (Figure 4.5). VAT and EAT accelerate coronary atherosclerosis, insulin resistance, and hypertension, both in obese and non-obese individuals.63,79–81 SAT, however, does not appear to be associated with cardiovascular disease.82,83 Among a multiethnic cohort, VAT accumulation disproportionately increased risk of developing HFpEF and HFpEF-related hospitalizations, whereas SAT had no effect on HFpEF.19
Cardiovascular System and Muscle
Published in George W. Casarett, Radiation Histopathology: Volume II, 2019
The epicardium, the thin outer layer of the heart, is analogous to the outer or adven-tial layer of the blood vessel walls and is composed of a single layer of mesothelial cells covering the free surface and resting on a thin layer of connective tissue containing networks of elastic fibers, many nervous elements, and blood vessels. The epicardium is essentially the visceral layer of the pericardium. The parietal layer of the pericardium is a serous membrane, composed of a thin layer of connective tissue covered by a simple layer of mesothelial cells.
The heart
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
The wall of the heart has three layers: EpicardiumEndocardiumMyocardium
The Effect of Mild Hypothermia on Nogo-A and Neurological Function in the Brain after Cardiopulmonary Resuscitation in Rats
Published in Fetal and Pediatric Pathology, 2022
Continuous thin current communication at a frequency of 50 Hz and 10 V was used to achieve electrophotoluminescence of the epicardium via the esophagus, which contributed to ventricular fibrillation. After electrophotoluminescence had been initiated, breathing machine was stopped and ventilation was monitored. After 3 min, electrophotoluminescence was stopped and sudden cardiac arrest was maintained for 6 min when the average arterial pressure was lower than 20 mmHg. CPR was then performed in accordance with the Utstein model [13]. Chest compressions were performed, and with reference to observed changes in electrocardiogram waveform, 5 J/kg direct current single-phase wave was used to achieve electric shock defibrillation once per min if ventricular rhythm was detected. If autonomous cardiac rhythm was not recovered within 3 min, 1:10,000 epinephrine solution (20 μg/kg) was injected intravenously once every 3 min until ROSC occurred or the experiment was stopped.
Epicardial adipose tissue predicted prolonged QTc interval in patients with arterial hypertension
Published in Clinical and Experimental Hypertension, 2021
Ahmet Seyda Yılmaz, Göksel Çinier, Ömer Faruk Çırakoğlu, Mustafa Çetin
Epicardial adipose tissue (EAT) is the true visceral adipose depot of the heart and serves as a local and endocrine organ. It was shown in previous studies to be the mediator of the cardiac autonomic and inflammatory functions. EAT causes electrical and structural changes in the myocardium with directly infiltrating the myocardial tissue and with its endocrine and paracrine functions through adipokines, fibrocytes, growth factors, and mediators such as cytokines (5). EAT has been shown to be associated with atrial arrhythmias such as atrial fibrillation (AF) and interatrial block(6). It has also been shown in previous studies to be associated with ventricular arrhythmias, but its relationship with electrocardiographic markers of ventricular arrhythmia in patients with AH has not been studied before.
Non-invasive imaging techniques to assess myocardial perfusion
Published in Expert Review of Medical Devices, 2020
Olivier Villemain, Jérôme Baranger, Zakaria Jalal, Christopher Lam, Jérémie Calais, Mathieu Pernot, Barbara Cifra, Mark K. Friedberg, Luc Mertens
As coronary artery disease affecting myocardial perfusion is considered to be the leading cause of cardiovascular mortality and morbidity, evaluation of myocardial perfusion plays a central role in diagnostic work-up and therapeutic decision-making in affected patients. While evaluation of coronary artery anatomy by catheterization is considered the gold standard technique, noninvasive imaging techniques play an important role in coronary artery detection and selection of patients needing an invasive evaluation. Different techniques are available that provide information on regional myocardial blood flow. Studying myocardial perfusion is essential in the diagnostic work-up of patients presenting with symptoms suggestive of coronary artery disease [1]. These techniques can be helpful in selecting the appropriate medical or interventional treatments. In the assessment of patients with suspected CAD different diagnostic questions are important including: 1. Anatomy of the epicardial coronary arteries with identification of coronary artery anatomical abnormalities and stenoses; 2. The distal coronary artery bed and microcirculation that can be affected in diseases such as diabetes and other microangiopathies; 3. Regional myocardial perfusion in relationship to regional myocardial function; 4. Coronary flow reserve with study of myocardial perfusion during pharmacological or physiological stress in relationship to regional myocardial function; 5. In ischemic areas, study myocardial viability and possible reversibility of myocardial function after reperfusion.