ReviewFrontiers in cardiovascular medicine2026
Epicardial adipose tissue as a metabolically active visceral fat depot: an emerging target in cardiovascular disease.
Review in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
5 authors.
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Abstract
Background: Epicardial adipose tissue (EAT) is a metabolically and endocrinologically active visceral fat depot with unique anatomical proximity to the myocardium, and is increasingly recognized as relevant to cardiovascular health and disease. Its anatomical position, in direct contact with the myocardium and coronary arteries without an intervening fascial barrier, is consistent with paracrine and vasocrine signaling toward adjacent cardiac structures. Objective: This review aims to provide a comprehensive analysis of EAT biology, from its physiological roles in lipid homeostasis, mechanical protection, and thermogenesis, to its pathological transformation in the context of obesity, metabolic syndrome, and coronary artery disease. Methods: A narrative review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Embase, focusing on studies published between January 2000 and December 2025. Human data-particularly from prospective cohorts, randomized trials, and meta-analyses-were prioritized over preclinical and Results: Under pathological conditions, EAT undergoes structural and functional remodeling characterized by adipocyte hypertrophy, immune cell infiltration, dysregulated adipokine secretion, and a shift from a beige-like thermogenic phenotype to a white, pro-inflammatory depot. These changes promote cardiac fibrosis through activation of fibroblast-to-myofibroblast differentiation via TGF- Conclusions: EAT is an emerging therapeutic target and candidate biomarker in cardiovascular medicine. Echocardiographic thickness and CT/MRI volumetric measurements have shown prognostic associations with adverse cardiovascular events, although standardized cut-off values across imaging modalities and large prospective outcomes trials specifically validating EAT-based risk stratification remain lacking. Strategies that may favorably modulate EAT remodeling, including GLP-1 receptor agonists and conceptual approaches to promote re-browning, represent emerging-but still preliminary-therapeutic directions whose independent cardiovascular benefit requires further investigation.
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