The epicardium as a hub for heart regeneration

Nat Rev Cardiol. 2018 Oct;15(10):631-647. doi: 10.1038/s41569-018-0046-4.


After decades of directed research, no effective regenerative therapy is currently available to repair the injured human heart. The epicardium, a layer of mesothelial tissue that envelops the heart in all vertebrates, has emerged as a new player in cardiac repair and regeneration. The epicardium is essential for muscle regeneration in the zebrafish model of innate heart regeneration, and the epicardium also participates in fibrotic responses in mammalian hearts. This structure serves as a source of crucial cells, such as vascular smooth muscle cells, pericytes, and fibroblasts, during heart development and repair. The epicardium also secretes factors that are essential for proliferation and survival of cardiomyocytes. In this Review, we describe recent advances in our understanding of the biology of the epicardium and the effect of these findings on the candidacy of this structure as a therapeutic target for heart repair and regeneration.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Cell Differentiation
  • Cell Lineage
  • Cell Proliferation
  • Cell Survival
  • Disease Models, Animal
  • Heart Diseases / metabolism
  • Heart Diseases / pathology*
  • Heart Diseases / physiopathology
  • Heart Diseases / therapy
  • Humans
  • Mice, Transgenic
  • Organogenesis
  • Pericardium / metabolism
  • Pericardium / pathology*
  • Pericardium / physiopathology
  • Recovery of Function
  • Regeneration*
  • Regenerative Medicine / methods
  • Signal Transduction