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

Sarah A. Goldman, Juan Antonio Requena-Ibanez, Ana Devesa, Carlos G. Santos-Gallego, Juan José Badimon, Valentin Fuster

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


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.

Original languageEnglish
Article number100657
JournalJACC: Advances
Issue number9
StatePublished - Nov 2023


  • atrial fibrillation
  • epicardial adipose tissue
  • heart failure with preserved ejection fraction
  • inflammation


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