Uncovering the Role of Epicardial Adipose Tissue in Heart Failure With Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure. Obesity is a modifiable risk factor of HFpEF; however, body mass index provides limited information on visceral adiposity and patients with similar anthropometrics can present variable cardiovascular risk. Epicardial adipose tissue (EAT) is the closest fat deposit to the heart and has been proposed as a biomarker of visceral adiposity. EAT may be particularly important for cardiac function, because of its location (under the pericardium) and because it acts as a metabolically active endocrine organ (which can produce both beneficial and detrimental cytokines). In this paper, the authors review the role of EAT in normal and pathologic conditions and discuss the noninvasive imaging modalities that allow its identification. This review highlights EAT implications in HFpEF and discuss new therapies that act on EAT and might also exert beneficial effects on the cardiovascular system.

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© 2023 The Authors.

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The project that gave rise to these results received the support of a fellowship from 10.13039/100010434‘la Caixa’ Foundation (ID 100010434). The fellowship code is LCF/BQ/EU21/11890141. Dr Devesa is recipient of an Alfonso Martin Escudero grant. Dr Santos-Gallego is supported by the Robert Winn Career Development Award. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.