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Review
- Pathophysiology
- Epicardial Adipose Tissue and Heart Failure, Friend or Foe?
- Dong-Hyuk Cho, Seong-Mi Park
- Diabetes Metab J. 2024;48(3):373-384. Published online February 2, 2024
- DOI: https://doi.org/10.4093/dmj.2023.0190
- 5,905 View
- 395 Download
- 10 Web of Science
- 12 Crossref
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Abstract
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PubReader 
ePub - Heart failure (HF) management guidelines recommend individualized assessments based on HF phenotypes. Adiposity is a known risk factor for HF. Recently, there has been an increased interest in organ-specific adiposity, specifically the role of the epicardial adipose tissue (EAT), in HF risk. EAT is easily assessable through various imaging modalities and is anatomically and functionally connected to the myocardium. In pathological conditions, EAT secretes inflammatory cytokines, releases excessive fatty acids, and increases mechanical load on the myocardium, resulting in myocardial remodeling. EAT plays a pathophysiological role in characterizing both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). In HFrEF, EAT volume is reduced, reflecting an impaired metabolic reservoir, whereas in HFpEF, the amount of EAT is associated with worse biomarker and hemodynamic profiles, indicating increased EAT activity. Studies have examined the possibility of therapeutically targeting EAT, and recent studies using sodium glucose cotransporter 2 inhibitors have shown potential in reducing EAT volume. However, further research is required to determine the clinical implications of reducing EAT activity in patients with HF.
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Citations
Citations to this article as recorded by
- Empagliflozin in diabetic cardiomyopathy: elucidating mechanisms, therapeutic potentials, and future directions
Aiswarya Jaiswal, Poonam Yadav, Pushkar Singh Rawat, Maninder Kaur, Srivalliputturu Sarath Babu, Amit Khurana, Jasvinder Singh Bhatti, Umashanker Navik
Molecular Biology Reports.2025;[Epub] CrossRef - Mediating Role of Blood Metabolites in the Relationship Between Immune Cell Traits and Heart Failure: A Mendelian Randomization and Mediation Analysis
Yi Liu, Chenfu Shen, Yu Cao
Journal of the American Heart Association.2025;[Epub] CrossRef - Sex Difference in the Association Between Regional Adipose Tissue and Left Ventricular Hypertrophy
In-Jeong Cho, Sang-Eun Lee, Wook-Bum Pyun
Journal of Clinical Medicine.2025; 14(7): 2399. CrossRef - Obesity and its management in primary care setting
Mahmoud Ibrahim, Ebtesam M. Ba-Essa, Jessica A. Alvarez, Jason Baker, Vincenzo Bruni, Avivit Cahn, Antonio Ceriello, Francesco Cosentino, Melanie J. Davies, Francesco De Domenico, Robert H. Eckel, Allon N. Friedman, Jonathan Goldney, Omer Hamtzany, Scott
Journal of Diabetes and its Complications.2025; : 109045. CrossRef - New Mechanisms to Prevent Heart Failure with Preserved Ejection Fraction Using Glucagon-like Peptide-1 Receptor Agonism (GLP-1 RA) in Metabolic Syndrome and in Type 2 Diabetes: A Review
Jorge E. Jalil, Luigi Gabrielli, María Paz Ocaranza, Paul MacNab, Rodrigo Fernández, Bruno Grassi, Paulina Jofré, Hugo Verdejo, Monica Acevedo, Samuel Cordova, Luis Sanhueza, Douglas Greig
International Journal of Molecular Sciences.2024; 25(8): 4407. CrossRef - Association of body adiposity with left ventricular concentric remodeling and diastolic dysfunction
In‐Jeong Cho, Sang‐Eun Lee, Wook Bum Pyun
Echocardiography.2024;[Epub] CrossRef - Statin Therapy Mitigates Oxidative Stress in Epicardial and Perivascular Adipose Tissue: A Pilot Study in Cardiac Surgery Patients
Laurentiu Braescu
Timisoara Medical Journal.2024; 2024(1): 1. CrossRef - Cardiometabolic Crossroads: Obesity, Sleep-Disordered Breathing, and Epicardial Adipose Tissue in Heart Failure with Preserved Ejection Fraction – A Mini-Review
Fulvio Cacciapuoti, Ciro Mauro, Valentina Capone, Angelo Sasso, Luca Gaetano Tarquinio, Federico Cacciapuoti
Heart and Mind.2024;[Epub] CrossRef - Beyond weight loss: the potential of glucagon-like peptide-1 receptor agonists for treating heart failure with preserved ejection fraction
Tian-Yu Wang, Qiang Yang, Xin-Yi Cheng, Jun-Can Ding, Peng-Fei Hu
Heart Failure Reviews.2024; 30(1): 17. CrossRef - Predictive value of epicardial adipose tissue volume measured in diagnosis and prognosis of patients with HFPEF
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Experimental Gerontology.2024; 198: 112618. CrossRef - Huangqi-Danshen decoction improves heart failure by regulating pericardial adipose tissue derived extracellular vesicular miR-27a-3p to activate AMPKα2 mediated mitophagy
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Diabetes & Metabolism Journal.2024; 48(6): 1176. CrossRef
- Empagliflozin in diabetic cardiomyopathy: elucidating mechanisms, therapeutic potentials, and future directions
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