{"id":"https://openalex.org/W7225825445","doi":"https://doi.org/10.3389/fcvm.2026.1986624","title":"From cushion to culprit: pharmacological reversal of epicardial adipose tissue remodeling in obesity-related heart failure with preserved ejection fraction","display_name":"From cushion to culprit: pharmacological reversal of epicardial adipose tissue remodeling in obesity-related heart failure with preserved ejection fraction","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225825445","doi":"https://doi.org/10.3389/fcvm.2026.1986624"},"language":"en","primary_location":{"id":"doi:10.3389/fcvm.2026.1986624","doi":"https://doi.org/10.3389/fcvm.2026.1986624","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fcvm.2026.1986624","pdf_url":null,"source":{"id":"https://openalex.org/S2595413687","display_name":"Frontiers in Cardiovascular Medicine","issn_l":"2297-055X","issn":["2297-055X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Cardiovascular Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3389/fcvm.2026.1986624","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5130000527","display_name":"Yanhui Li","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Yanhui Li","raw_affiliation_strings":["Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161431772","display_name":"Jianjuan Chang","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jianjuan Chang","raw_affiliation_strings":["Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161441673","display_name":"Zhi Liu","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Zhi Liu","raw_affiliation_strings":["Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161488014","display_name":"Juan Liu","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Juan Liu","raw_affiliation_strings":["Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Endocrinology, Chengdu Qingbaijiang District People\u2019s Hospital","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5161488014"],"corresponding_institution_ids":[],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"13","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12979","display_name":"Cardiovascular Disease and Adiposity","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12979","display_name":"Cardiovascular Disease and Adiposity","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10198","display_name":"Heart Failure Treatment and Management","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11962","display_name":"Cardiac Fibrosis and Remodeling","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7609000205993652},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.6635000109672546},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6492000222206116},{"id":"https://openalex.org/C2780559512","wikidata":"https://www.wikidata.org/wiki/Q605709","display_name":"Fibrosis","level":2,"score":0.5879999995231628},{"id":"https://openalex.org/C2778198053","wikidata":"https://www.wikidata.org/wiki/Q181754","display_name":"Heart failure","level":2,"score":0.570900022983551},{"id":"https://openalex.org/C2777099384","wikidata":"https://www.wikidata.org/wiki/Q3799239","display_name":"Heart failure with preserved ejection fraction","level":4,"score":0.544700026512146},{"id":"https://openalex.org/C171089720","wikidata":"https://www.wikidata.org/wiki/Q193583","display_name":"Adipose tissue","level":2,"score":0.5282999873161316},{"id":"https://openalex.org/C2779537366","wikidata":"https://www.wikidata.org/wiki/Q7920323","display_name":"Ventricular remodeling","level":3,"score":0.45579999685287476},{"id":"https://openalex.org/C78085059","wikidata":"https://www.wikidata.org/wiki/Q641303","display_name":"Ejection fraction","level":3,"score":0.4004000127315521},{"id":"https://openalex.org/C2778875491","wikidata":"https://www.wikidata.org/wiki/Q193302","display_name":"Pericardium","level":2,"score":0.39309999346733093},{"id":"https://openalex.org/C151955695","wikidata":"https://www.wikidata.org/wiki/Q654528","display_name":"White adipose tissue","level":3,"score":0.3644999861717224},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.3325999975204468},{"id":"https://openalex.org/C120770815","wikidata":"https://www.wikidata.org/wiki/Q14859627","display_name":"Vasodilation","level":2,"score":0.31790000200271606},{"id":"https://openalex.org/C57900726","wikidata":"https://www.wikidata.org/wiki/Q492905","display_name":"Diastole","level":3,"score":0.3041999936103821},{"id":"https://openalex.org/C3018763269","wikidata":"https://www.wikidata.org/wiki/Q5038318","display_name":"Myocardial fibrosis","level":3,"score":0.2865000069141388},{"id":"https://openalex.org/C2780972559","wikidata":"https://www.wikidata.org/wiki/Q550061","display_name":"Endothelial dysfunction","level":2,"score":0.27880001068115234},{"id":"https://openalex.org/C85378888","wikidata":"https://www.wikidata.org/wiki/Q721856","display_name":"Endocardium","level":2,"score":0.27639999985694885},{"id":"https://openalex.org/C167414201","wikidata":"https://www.wikidata.org/wiki/Q1955391","display_name":"Muscle hypertrophy","level":2,"score":0.27489998936653137},{"id":"https://openalex.org/C24595384","wikidata":"https://www.wikidata.org/wiki/Q17143767","display_name":"Volume overload","level":3,"score":0.26579999923706055},{"id":"https://openalex.org/C2776157398","wikidata":"https://www.wikidata.org/wiki/Q497232","display_name":"Coronary circulation","level":3,"score":0.2630999982357025},{"id":"https://openalex.org/C2776914184","wikidata":"https://www.wikidata.org/wiki/Q101991","display_name":"Inflammation","level":2,"score":0.25999999046325684},{"id":"https://openalex.org/C2780745355","wikidata":"https://www.wikidata.org/wiki/Q193583","display_name":"Stromal vascular fraction","level":3,"score":0.2583000063896179},{"id":"https://openalex.org/C44353895","wikidata":"https://www.wikidata.org/wiki/Q6556772","display_name":"Lipotoxicity","level":4,"score":0.25540000200271606},{"id":"https://openalex.org/C2776992346","wikidata":"https://www.wikidata.org/wiki/Q111140","display_name":"Endothelium","level":2,"score":0.25290000438690186}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3389/fcvm.2026.1986624","doi":"https://doi.org/10.3389/fcvm.2026.1986624","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fcvm.2026.1986624","pdf_url":null,"source":{"id":"https://openalex.org/S2595413687","display_name":"Frontiers in Cardiovascular Medicine","issn_l":"2297-055X","issn":["2297-055X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Cardiovascular Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3389/fcvm.2026.1986624","doi":"https://doi.org/10.3389/fcvm.2026.1986624","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fcvm.2026.1986624","pdf_url":null,"source":{"id":"https://openalex.org/S2595413687","display_name":"Frontiers in Cardiovascular Medicine","issn_l":"2297-055X","issn":["2297-055X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-40","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Cardiovascular Medicine","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":170,"referenced_works":["https://openalex.org/W1501655398","https://openalex.org/W1631449371","https://openalex.org/W1733618631","https://openalex.org/W1738779435","https://openalex.org/W1967898940","https://openalex.org/W1976143502","https://openalex.org/W1976844022","https://openalex.org/W1978598508","https://openalex.org/W1979811843","https://openalex.org/W1990651739","https://openalex.org/W1998855918","https://openalex.org/W2019804658","https://openalex.org/W2032020948","https://openalex.org/W2032520632","https://openalex.org/W2041475214","https://openalex.org/W2049514014","https://openalex.org/W2050044059","https://openalex.org/W2051051060","https://openalex.org/W2058679403","https://openalex.org/W2059087651","https://openalex.org/W2082053713","https://openalex.org/W2086581449","https://openalex.org/W2087513437","https://openalex.org/W2091441230","https://openalex.org/W2091997631","https://openalex.org/W2098267336","https://openalex.org/W2099066805","https://openalex.org/W2106914263","https://openalex.org/W2107542389","https://openalex.org/W2120861740","https://openalex.org/W2120870148","https://openalex.org/W2137983021","https://openalex.org/W2143149722","https://openalex.org/W2145729769","https://openalex.org/W2159549492","https://openalex.org/W2161496857","https://openalex.org/W2168832391","https://openalex.org/W2169912078","https://openalex.org/W2190245538","https://openalex.org/W2253174262","https://openalex.org/W2254631758","https://openalex.org/W2264833793","https://openalex.org/W2269684859","https://openalex.org/W2282836684","https://openalex.org/W2513699385","https://openalex.org/W2556942741","https://openalex.org/W2586356777","https://openalex.org/W2588757737","https://openalex.org/W2619744261","https://openalex.org/W2647098128","https://openalex.org/W2742187097","https://openalex.org/W2756345767","https://openalex.org/W2768810688","https://openalex.org/W2778464949","https://openalex.org/W2790400225","https://openalex.org/W2790537823","https://openalex.org/W2802489447","https://openalex.org/W2808782290","https://openalex.org/W2886566773","https://openalex.org/W2929875152","https://openalex.org/W2936593438","https://openalex.org/W2937422733","https://openalex.org/W2940356584","https://openalex.org/W2940971523","https://openalex.org/W2950568032","https://openalex.org/W2952048439","https://openalex.org/W2955406063","https://openalex.org/W2967302163","https://openalex.org/W2970127500","https://openalex.org/W2970381905","https://openalex.org/W2972655824","https://openalex.org/W2983343189","https://openalex.org/W2984316435","https://openalex.org/W2989579906","https://openalex.org/W2991235749","https://openalex.org/W2996146863","https://openalex.org/W3009289166","https://openalex.org/W3012225375","https://openalex.org/W3038114785","https://openalex.org/W3102766101","https://openalex.org/W3108676144","https://openalex.org/W3125158701","https://openalex.org/W3149750390","https://openalex.org/W3162223062","https://openalex.org/W3184013863","https://openalex.org/W3186811750","https://openalex.org/W3202951828","https://openalex.org/W3211416842","https://openalex.org/W3213701427","https://openalex.org/W4206170515","https://openalex.org/W4220961850","https://openalex.org/W4221093274","https://openalex.org/W4221100763","https://openalex.org/W4224247700","https://openalex.org/W4224939583","https://openalex.org/W4225012009","https://openalex.org/W4233349015","https://openalex.org/W4281621547","https://openalex.org/W4282969219","https://openalex.org/W4284677278","https://openalex.org/W4295420683","https://openalex.org/W4297199617","https://openalex.org/W4303199619","https://openalex.org/W4307756529","https://openalex.org/W4308054827","https://openalex.org/W4318619190","https://openalex.org/W4321153095","https://openalex.org/W4321225557","https://openalex.org/W4321375952","https://openalex.org/W4322490875","https://openalex.org/W4361218842","https://openalex.org/W4376890914","https://openalex.org/W4384500735","https://openalex.org/W4385462386","https://openalex.org/W4386154055","https://openalex.org/W4386909811","https://openalex.org/W4387745442","https://openalex.org/W4388007270","https://openalex.org/W4388249299","https://openalex.org/W4389849306","https://openalex.org/W4390444572","https://openalex.org/W4392302994","https://openalex.org/W4392761114","https://openalex.org/W4392816577","https://openalex.org/W4392960571","https://openalex.org/W4392966539","https://openalex.org/W4393379002","https://openalex.org/W4394061375","https://openalex.org/W4396930674","https://openalex.org/W4398159142","https://openalex.org/W4399185467","https://openalex.org/W4399350206","https://openalex.org/W4399671023","https://openalex.org/W4400117326","https://openalex.org/W4400349895","https://openalex.org/W4400849169","https://openalex.org/W4401286835","https://openalex.org/W4401797819","https://openalex.org/W4403171671","https://openalex.org/W4403852456","https://openalex.org/W4404114247","https://openalex.org/W4404437149","https://openalex.org/W4404467861","https://openalex.org/W4404470149","https://openalex.org/W4404756885","https://openalex.org/W4409392868","https://openalex.org/W4409486014","https://openalex.org/W4409867731","https://openalex.org/W4409987885","https://openalex.org/W4410813035","https://openalex.org/W4411580535","https://openalex.org/W4412514207","https://openalex.org/W4412700467","https://openalex.org/W4413293415","https://openalex.org/W4413305777","https://openalex.org/W4414347058","https://openalex.org/W4414439080","https://openalex.org/W4414483875","https://openalex.org/W4416056515","https://openalex.org/W4416249301","https://openalex.org/W4416766299","https://openalex.org/W4416957781","https://openalex.org/W4417121404","https://openalex.org/W4417497606","https://openalex.org/W7128933696","https://openalex.org/W7131115415","https://openalex.org/W7134835806","https://openalex.org/W7154738571","https://openalex.org/W7161543274","https://openalex.org/W7162400219"],"related_works":[],"abstract_inverted_index":{"Obesity":[0],"is":[1],"a":[2,48,92,115,261,265],"core":[3],"driver":[4],"of":[5,62,81,194,241,257],"heart":[6],"failure":[7],"with":[8,43,58,130,166],"preserved":[9],"ejection":[10],"fraction":[11],"(HFpEF),":[12],"yet":[13],"conventional":[14],"therapies":[15,231],"target":[16,60,263],"hemodynamics":[17],"and":[18,35,46,78,105,125,151,158,171,177,189,221,229,252,264],"neurohormonal":[19],"axes":[20,133],"rather":[21],"than":[22],"this":[23],"upstream":[24],"factor.":[25],"Epicardial":[26],"adipose":[27],"tissue":[28],"(EAT),":[29],"located":[30],"between":[31],"the":[32,36,39,44,53,96,108,131,139,181,211,217,239,254],"visceral":[33,64],"pericardium":[34],"myocardium,":[37],"shares":[38],"coronary":[40],"blood":[41],"supply":[42],"myocardium":[45,140],"lacks":[47],"fascial":[49],"barrier,":[50],"giving":[51],"it":[52],"most":[54,182,212],"direct,":[55],"fascia-free":[56],"interface":[57],"its":[59,250],"organ":[61],"any":[63],"fat":[65],"depot.":[66],"Healthy":[67],"EAT":[68,87,137,199,258],"maintains":[69],"cardiac":[70],"metabolic":[71],"homeostasis":[72],"through":[73,141],"fatty":[74],"acid":[75],"buffering,":[76],"thermogenesis,":[77],"paracrine":[79],"secretion":[80],"protective":[82],"adipokines.":[83],"In":[84],"obesity,":[85],"however,":[86],"undergoes":[88],"pathological":[89],"remodeling":[90,243],"along":[91],"\u201cquantity\u2013quality":[93],"dual":[94],"axis\u201d:":[95],"quantit":[97,218],"y":[98,110,219],"axis":[99,111],"manifests":[100],"as":[101,259],"expansion":[102],"in":[103,244],"volume":[104],"thickness,":[106],"while":[107],"qualit":[109],"encompasses":[112],"browning":[113],"loss,":[114],"secretome":[116],"shift":[117],"from":[118],"anti-inflammatory":[119],"to":[120],"pro-inflammatory,":[121],"lipotoxic":[122],"lipid":[123],"accumulation,":[124],"an":[126],"imbalanced":[127],"inflammatory":[128,147],"microenvironment,":[129],"two":[132],"progressing":[134],"asynchronously.":[135],"Remodeled":[136],"injures":[138],"four":[142],"interconnected":[143],"mechanisms\u2014mechanical":[144],"constraint,":[145],"paracrine\u2013vasocrine":[146],"cascades,":[148],"cardiomyocyte":[149,160],"lipotoxicity,":[150],"microvascular":[152],"dysfunction\u2014that":[153],"converge":[154],"on":[155,216],"myocardial":[156],"fibrosis":[157],"increased":[159],"stiffness.":[161],"These":[162],"changes":[163],"are":[164],"associated":[165],"left":[167],"ventricular":[168],"diastolic":[169],"dysfunction":[170],"HFpEF.":[172],"Pharmacologically,":[173],"incretin":[174],"analogs":[175],"(semaglutide":[176],"tirzepatide)":[178],"have":[179],"established":[180],"complete":[183],"evidence":[184,215],"chain,":[185],"spanning":[186],"mechanistic,":[187],"imaging":[188],"clinical":[190,196],"endpoints,":[191],"but":[192],"mediation":[193],"their":[195],"benefit":[197],"by":[198],"change":[200],"has":[201],"not":[202],"been":[203],"established;":[204],"sodium\u2013glucose":[205],"cotransporter":[206],"2":[207],"(SGLT2)":[208],"inhibitors":[209],"provide":[210],"systematic":[213],"structural":[214],"axis;":[220],"statins,":[222],"thiazolidinediones,":[223],"metformin,":[224],"\u03b2":[225],"3-adrenergic":[226],"receptor":[227],"agonists,":[228],"microRNA-based":[230],"also":[232],"show":[233],"dual-axis":[234],"potential.":[235],"This":[236],"review":[237],"synthesizes":[238],"mechanisms":[240],"quantity\u2013quality":[242],"EAT,":[245],"evaluates":[246],"pharmacological":[247],"strategies":[248],"for":[249],"reversal,":[251],"discusses":[253],"translational":[255],"prospects":[256],"both":[260],"therapeutic":[262],"surrogate":[266],"endpoint.":[267]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}
