The Role of the Epicardium During Heart Development and Repair
Open accessAbstract
The heart is lined by a single layer of mesothelial cells called the epicardium that provides important cellular contributions for embryonic heart formation. The epicardium harbors a population of progenitor cells that undergo epithelial-to-mesenchymal transition displaying characteristic conversion of planar epithelial cells into multipolar and invasive mesenchymal cells before differentiating into nonmyocyte cardiac lineages, such as vascular smooth muscle cells, pericytes, and fibroblasts. The epicardium is also a source of paracrine cues that are essential for fetal cardiac growth, coronary vessel patterning, and regenerative heart repair. Although the epicardium becomes dormant after birth, cardiac injury reactivates developmental gene programs that stimulate epithelial-to-mesenchymal transition; however, it is not clear how the epicardium contributes to disease progression or repair in the adult. In this review, we will summarize the molecular mechanisms that control epicardium-derived progenitor cell migration, and the functional contributions of the epicardium to heart formation and cardiomyopathy. Future perspectives will be presented to highlight emerging therapeutic strategies aimed at harnessing the regenerative potential of the fetal epicardium for cardiac repair.
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EAT is a major source of mesenchymal stem cells that can provide regeneration and repair of injured myocardium.
“Additionally, EAT is a major source of mesenchymal stem cells that, transiting through the shared microcirculation, can provide the regeneration and repair of injured myocardium [48,49].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [48]
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- Authors
- Quijada, P., Trembley, M. A., & Small, E. M.
- Affiliations
- University of Rochester Medicine (US)
- Boston Children's Hospital (US)
- Corresponding author
- Small, Eric M.
- Venue
- Circulation Research
- Published
- 2020-01-31
- Volume
- 126
- Issue
- 3
- Pages
- 377-394
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- PMC
- PMC7000171
- OpenAlex
- W3003280117
- Cited by
- 201
- References
- 176
- Citations by year
- 2026: 31 · 2025: 29 · 2024: 32 · 2023: 30 · 2022: 41 · 2021: 26 · 2020: 11 · 2019: 1
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Howard Hughes Medical Institute
- National Institutes of Health (UL1TR002001)
- National Heart, Lung, and Blood Institute (R01HL133761, R01HL136179, R01HL120919, T32HL066988, F32HL134206, R01HL144867, T32HL007572)
- National Institute of General Medical Sciences (T32GM068411)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Health Sciences › Medicine › Genetics › Mesenchymal stem cell research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- epicardium, heart development, cardiac repair, epithelial-mesenchymal transition, epicardial progenitor cells, paracrine signaling, cardiac fibroblasts, pericytes, vascular smooth muscle cells, cardiomyopathy, cardiac regeneration, cardiomyocyte differentiation
- MeSH terms
- Animals, Heart Diseases, Humans, Myocardium, Pericardium, Regeneration, Paracrine Communication
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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