Epicardial Fat Expansion in Diabetic and Obese Patients with Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype
Open accessAbstract
Graphical Abstract Epicardial adipose tissue (EAT)-related heart failure with preserved ejection fraction (HFpEF). Obesity and type 2 diabetes mellitus (T2DM) are common triggers of HFpEF, frequently associated with EAT expansion. EAT plays metabolic and mechanical roles in HFpEF developmentviapara/vasocrine factors and pericardial restrain, respectively. Life-style modifications including healthy diet and regular exercise can quash the EAT expansion. Statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and fat-modulating antidiabetics including metformin, sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) agonists can target EAT. FFA, free fatty acids; AGEs, advanced glycation end-products; NO, nitric oxide; ROS, reactive oxygen species; Ang-II, angiotensin II; TGF-β, Transforming growth factor beta; MCP-1, monocyte chemoattractant protein 1; IL-6, interleukin 6; TNF-α, tumor necrosis factor alpha. Figure createdviaServier Medical Art and BioRender tools.
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CMR offers potential multiple evaluations of underlying myocardial ischemia, storage diseases like amyloidosis, intramyocardial triacylglycerol accumulation, and diffuse myocardial fibrosis, in addition to the evaluation of systo-diastolic function and myocardial work.
“Apart from being radiation-free, this technique offers potential multiple evaluations of underlying myocardial ischemia, storage diseases like amyloidosis, intramyocardial triacylglycerol accumulation, and diffuse myocardial fibrosis, in addition to the evaluation of systo-diastolic function and myocardial work [112].”
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 [112]
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- Authors
- Elsanhoury, A., Nelki, V., Kelle, S., Van Linthout, S., & Tschöpe, C.
- Affiliations
- German Centre for Cardiovascular Research (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Deutsches Herzzentrum der Charité (DE)
- Corresponding author
- Tschöpe, Carsten
- Venue
- Frontiers in Cardiovascular Medicine
- Publisher
- Frontiers Media SA
- Published
- 2021-09-17
- Volume
- 8
- Pages
- 720690-720690
- ISSN
- 2297-055X (ISSN-L)
- PMC
- PMC8484763
- OpenAlex
- W3200019072
- Cited by
- 51
- References
- 142
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 16 · 2023: 7 · 2022: 16
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Cardiovascular Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- epicardial adipose tissue, heart failure with preserved ejection fraction, type 2 diabetes, obesity, HFpEF phenotypes, statins, PCSK9 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, metformin, free fatty acids, advanced glycation end products, inflammation, lifestyle modification
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