Evidence mapPaperPMID 42433538Full record

ReviewQuantitative imaging in medicine and surgery2026

Mediastinal adipose tissue as an active player in cardiovascular disease: a multimodality imaging narrative review.

Lorenza Cananzi, Federico Greco, Andrea Buoso, Caterina Bernetti, Luca Pugliese, Gianfranco Di Gennaro, Bruno Beomonte Zobel, Carlo Augusto Mallio

Abstract readReview
In one paragraph

Review in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lorenza CananziFondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.
Federico GrecoResearch Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy.ORCID https://orcid.org/0000-0002-9477-0238
Andrea BuosoFondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.
Caterina BernettiFondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.
Luca PuglieseDepartment of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Radiology Unit, Sant'Andrea University Hospital, Roma, Italy.
Gianfranco Di GennaroDepartment of Health Sciences, Chair of Medical Statistics, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
Bruno Beomonte ZobelFondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.
Carlo Augusto MallioFondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.ORCID https://orcid.org/0000-0002-0149-0801

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Objective: Mediastinal adipose tissue comprises several distinct fat depots, including epicardial, pericoronary, pericardial, and paracardial adipose tissue, which surround the heart and great vessels and actively contribute to cardiovascular pathophysiology. Under physiological conditions, these adipose compartments exert protective metabolic and mechanical functions; however, in pathological states, their expansion and remodeling promote inflammation, endothelial dysfunction, fibrosis, and atherosclerotic progression. This narrative review aims to summarize the current evidence regarding the anatomical distribution, imaging assessment, and clinical implications of mediastinal adipose tissue in cardiovascular disease. Methods: A narrative review was conducted using PubMed, Scopus, and Web of Science databases, covering publications up to January 2026. Only articles published in English were considered. Original research articles and relevant reviews focusing on imaging, pathophysiology, and clinical implications of mediastinal adipose tissue were included. Reference lists of selected studies were additionally screened to identify additional relevant publications. Key Content and Findings: Computed tomography (CT) enables highly reproducible volumetric and qualitative assessment of cardiac adipose tissue, including inflammatory markers such as the fat attenuation index (FAI). Magnetic resonance imaging (MRI) provides excellent tissue characterization without ionizing radiation, whereas echocardiography represents a simple and widely available screening tool. Increased epicardial, pericoronary, and pericardial adipose tissue (PAT) burden has been consistently associated with coronary artery disease (CAD), atrial fibrillation (AF), and heart failure (HF), particularly HF with preserved ejection fraction (HFpEF). Emerging evidence also supports the potential role of artificial intelligence (AI) and radiomics for automated quantification and cardiovascular risk stratification. Conclusions: Mediastinal adipose tissue is increasingly recognized as an active biomarker and potential therapeutic target in cardiovascular disease. Multimodality imaging plays a central role in its evaluation by providing complementary anatomical, functional, and inflammatory information. Further standardization of imaging methodologies and validation of treatment-related changes are needed to support future clinical applications and personalized cardiovascular risk assessment.

Indexed as

Atrial fibrillation (AF)cardiac adipose tissuecardiovascular imagingcoronary artery disease (CAD)heart failure (HF)

Identifiers

PMID42433538
PMCPMC13349981

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.