2. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 2009; 53: 1925–32.
3. Чумакова Г.А., Веселовская Н.Г. Методы оценки висцерального ожирения в клинической практике. Рос. кардиолог. журн. 2016; 21 (4): 89–96. / Chumakova G.A., Veselovskaia N.G. Metody otsenki vistseral'nogo ozhireniia v klinicheskoi praktike. Ros. kardiolog. zhurn. 2016; 21 (4): 89–96. [In Russian]
4. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2005; 2 (10): 536–43.
5. Бубнова М.Г. Роль ожирения и висцерального жира сердца в запуске сердечно-сосудистого континуума. Клинические эффекты орлистата. Рос. мед. журн. 2014; 22 (2): 116–22. / Bubnova M.G. Rol' ozhireniia i vistseral'nogo zhira serdtsa v zapuske serdechno-sosudistogo kontinuuma. Klinicheskie effekty orlistata. Ros. med. zhurn. 2014; 22 (2): 116–22. [in Russian]
6. Wu Y, Zhang A, Hamilton DJ, Deng T. Epicardial Fat in the Maintenance of Cardiovascular Health. Methodist Debakey Cardiovasc J 2017; 13 (1): 20–4.
7. Iacobellis G. Epicardial and pericardial fat: close, but very different. Obesity (Silver Spring) 2009; 17 (4): 625; author reply 626-627.
8. Драпкина О.М., Корнеева О.Н., Драпкина Ю.С. Эпикардиальный жир: нападающий или запасной? Рацион. фармакотерапия в кардиологии. 2013; 9 (3): 287–91. / Drapkina OM, Korneyeva ON, Drapkina YUS. Epikardial’nyy zhir: napadayushchiy ili zapasnoy? Ratsional’naya farmakoterapiya v kardiologii 2013; 9 (3): 287–91. [in Russian]
9. Turer AT, Scherer PE. Adiponectin: mechanistic insights and clinical implications. Diabetologia 2012; 55 (9): 2319–26.
10. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol 2011; 11 (2): 85–97.
11. Wong HK, Cheung TT, Cheung BM. Adrenomedullin and cardiovascular diseases. JRSM Cardiovasc Dis 2012; 1 (5): pii: cvd.2012.012003.
12. Hirata Y, Kurobe H, Akaike M et al. Enhanced inflammation in epicardial fat in patients with coronary artery disease. Int Heart J 2011; 52 (3): 139–42.
13. Rajsheker S, Manka D, Blomkalns AL et al. Crosstalk between perivascular adipose tissue and blood vessels. Curr Opin Pharmacol 2010; 10 (2): 191–6.
14. Mazurek T, Zhang L, Zalewski A et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003; 108 (20): 2460–6.
15. Ito T, Nasu K, Terashima M et al. The impact of epicardial fat volume on coronary plaque vulnerability: insight from optical coherence tomography analysis. Eur Heart J Cardiovasc Imaging 2012; 13 (5): 408–15.
16. Sacks HS, Fain JN et al. Uncoupling protein-1 and related messenger ribonucleic acids in human epicardial and other adipose tissues: epicardial fat functioning as brown fat. J Clin Endocrinol Metab 2009; 94 (9): 3611–5.
17. Никифоров В.С., Никитин А.Э., Тыренко В.В., Свистов А.С. Ишемическая дисфункция миокарда. М.: АПКиППРО, 2005. / Nikiforov V.S., Nikitin A.E., Tyrenko V.V., Svistov A.S. Ishemicheskaia disfunktsiia miokarda. M.: APKiPPRO, 2005. [in Russian]
18. Pezeshkian M, Noori M, Najjarpour-Jabbari H et al. Fatty acid composition of epicardial and subcutaneous human adipose tissue. Metab Syndr Relat Disord 2009; 7 (2): 125–31.
19. Prati F, Arbustini E, Labellarte A et al. Eccentric atherosclerotic plaques with positive remodelling have a pericardial distribution: a permissive role of epicardial fat? Eur Heart J 2003; 24: 329–36.
20. Iacobellis G, Ribaudo MC, Zappaterreno A et al. Relation between epicardial adipose tissue and left ventricular mass. Am J Cardiol 2004; 94 (8): 1084–7.
21. Hirata Y, Tabata M, Kurobe H et al. Coronary atherosclerosis is associated with macrophage polarization in epicardial adipose tissue. J Am Coll Cardiol 2011; 58 (3): 248–55.
22. Weisberg SP, McCann D, Desai M et al. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003; 112(12): 1796-1808.
23. Baker AR, Harte AL, Howell N et al. Epicardial adipose tissue as a source of nuclear factor-kB and c-Jun N-terminal kinase medi-ated inflammation in patients with coronary artery disease. J Clin Endocrinol Metab 2009; 94 (1): 261–7.
24. Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res 2005; 96 (9): 939–49.
25. Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol 2015; 11 (6): 363–71.
26. Bertaso AG, Bertol D, Duncan BB et al. Epicardial fat: definition, measurements and systematic review of main outcomes. Arq Bras Cardiol 2013; 101 (1): e18-e28.
27. Salgado-Somoza A, Teijeira-Fernandez E, Fernandez AL et al. Proteomic analysis of epicardial and subcutaneous adipose tissue reveals differences in proteins involved in oxidative stress. Am J Physiol Heart Circ Physiol 2010; 299 (1): H202-H209.
28. Alexopoulos N, McLean DS, Janik M et al. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis 2010; 210 (1): 150–4.
29. Iacobellis G, Willens HJ, Barbaro G, Sharma AM. Threshold values of highrisk echocardiographic epicardial fat thickness. Obesity (Silver Spring) 2008; 16 (4): 887–92.
30. Jeong J, Jeong MH, Yun KH et al. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J 2007; 71 (4): 536–9.
31. Nelson MR, Mookadam F, Thota V et al. Epicardial fat: an additional measurement for subclinical atherosclerosis and cardiovascular risk stratification? J Am Soc Echocardiogr 2011; 24 (3): 339–45.

________________________________________________

1. Piepoli MF, Hoes AW, Agewall S et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2016; 37 (29): 2315–81.
2. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 2009; 53: 1925–32.
3. Chumakova G.A., Veselovskaia N.G. Metody otsenki vistseral'nogo ozhireniia v klinicheskoi praktike. Ros. kardiolog. zhurn. 2016; 21 (4): 89–96. [In Russian]
4. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2005; 2 (10): 536–43.
5. Bubnova M.G. Rol' ozhireniia i vistseral'nogo zhira serdtsa v zapuske serdechno-sosudistogo kontinuuma. Klinicheskie effekty orlistata. Ros. med. zhurn. 2014; 22 (2): 116–22. [in Russian]
6. Wu Y, Zhang A, Hamilton DJ, Deng T. Epicardial Fat in the Maintenance of Cardiovascular Health. Methodist Debakey Cardiovasc J 2017; 13 (1): 20–4.
7. Iacobellis G. Epicardial and pericardial fat: close, but very different. Obesity (Silver Spring) 2009; 17 (4): 625; author reply 626-627.
8. Drapkina OM, Korneyeva ON, Drapkina YUS. Epikardial’nyy zhir: napadayushchiy ili zapasnoy? Ratsional’naya farmakoterapiya v kardiologii 2013; 9 (3): 287–91. [in Russian]
9. Turer AT, Scherer PE. Adiponectin: mechanistic insights and clinical implications. Diabetologia 2012; 55 (9): 2319–26.
10. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol 2011; 11 (2): 85–97.
11. Wong HK, Cheung TT, Cheung BM. Adrenomedullin and cardiovascular diseases. JRSM Cardiovasc Dis 2012; 1 (5): pii: cvd.2012.012003.
12. Hirata Y, Kurobe H, Akaike M et al. Enhanced inflammation in epicardial fat in patients with coronary artery disease. Int Heart J 2011; 52 (3): 139–42.
13. Rajsheker S, Manka D, Blomkalns AL et al. Crosstalk between perivascular adipose tissue and blood vessels. Curr Opin Pharmacol 2010; 10 (2): 191–6.
14. Mazurek T, Zhang L, Zalewski A et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003; 108 (20): 2460–6.
15. Ito T, Nasu K, Terashima M et al. The impact of epicardial fat volume on coronary plaque vulnerability: insight from optical coherence tomography analysis. Eur Heart J Cardiovasc Imaging 2012; 13 (5): 408–15.
16. Sacks HS, Fain JN et al. Uncoupling protein-1 and related messenger ribonucleic acids in human epicardial and other adipose tissues: epicardial fat functioning as brown fat. J Clin Endocrinol Metab 2009; 94 (9): 3611–5.
17. Nikiforov V.S., Nikitin A.E., Tyrenko V.V., Svistov A.S. Ishemicheskaia disfunktsiia miokarda. M.: APKiPPRO, 2005. [in Russian]
18. Pezeshkian M, Noori M, Najjarpour-Jabbari H et al. Fatty acid composition of epicardial and subcutaneous human adipose tissue. Metab Syndr Relat Disord 2009; 7 (2): 125–31.
19. Prati F, Arbustini E, Labellarte A et al. Eccentric atherosclerotic plaques with positive remodelling have a pericardial distribution: a permissive role of epicardial fat? Eur Heart J 2003; 24: 329–36.
20. Iacobellis G, Ribaudo MC, Zappaterreno A et al. Relation between epicardial adipose tissue and left ventricular mass. Am J Cardiol 2004; 94 (8): 1084–7.
21. Hirata Y, Tabata M, Kurobe H et al. Coronary atherosclerosis is associated with macrophage polarization in epicardial adipose tissue. J Am Coll Cardiol 2011; 58 (3): 248–55.
22. Weisberg SP, McCann D, Desai M et al. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003; 112(12): 1796-1808.
23. Baker AR, Harte AL, Howell N et al. Epicardial adipose tissue as a source of nuclear factor-kB and c-Jun N-terminal kinase medi-ated inflammation in patients with coronary artery disease. J Clin Endocrinol Metab 2009; 94 (1): 261–7.
24. Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res 2005; 96 (9): 939–49.
25. Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol 2015; 11 (6): 363–71.
26. Bertaso AG, Bertol D, Duncan BB et al. Epicardial fat: definition, measurements and systematic review of main outcomes. Arq Bras Cardiol 2013; 101 (1): e18-e28.
27. Salgado-Somoza A, Teijeira-Fernandez E, Fernandez AL et al. Proteomic analysis of epicardial and subcutaneous adipose tissue reveals differences in proteins involved in oxidative stress. Am J Physiol Heart Circ Physiol 2010; 299 (1): H202-H209.
28. Alexopoulos N, McLean DS, Janik M et al. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis 2010; 210 (1): 150–4.
29. Iacobellis G, Willens HJ, Barbaro G, Sharma AM. Threshold values of highrisk echocardiographic epicardial fat thickness. Obesity (Silver Spring) 2008; 16 (4): 887–92.
30. Jeong J, Jeong MH, Yun KH et al. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J 2007; 71 (4): 536–9.
31. Nelson MR, Mookadam F, Thota V et al. Epicardial fat: an additional measurement for subclinical atherosclerosis and cardiovascular risk stratification? J Am Soc Echocardiogr 2011; 24 (3): 339–45.

А.В.Давыдова*1, В.С.Никифоров2, Ю.Ш.Халимов3

1 ГБУЗ «Камчатская краевая больница им. А.С.Лукашевского». 630003, Россия, Петропавловск-Камчатский, ул. Ленинградская, д. 112;
2 ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И.Мечникова» Минздрава России. 191015, Россия,  Санкт-Петербург, ул. Кирочная, д. 41;
3 ФГБВОУ ВО «Военно-медицинская академия им. С.М.Кирова» Минобороны России. 194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6
*anna.pustovaya@gmail.com

________________________________________________

2 I.I.Mechnikov State Northwestern Medical University of the Ministry of Health of the Russian Federation. 191015, Russian Federation, Saint Petersburg, ul. Kirochnaia, d. 41;
3 S.M.Kirov Military Medical Academy of the Ministry of Defence of the Russian Federation. 194044, Russian Federation, Saint Petersburg, ul. Akademika Lebedeva, d. 6
*anna.pustovaya@gmail.com