Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with diverse etiologies and pathophysiological factors. Obesity and type 2 diabetes mellitus (T2DM), conditions that coexist frequently, induce a cluster of metabolic and non-metabolic signaling derangements which are...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-09-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.720690/full |
| _version_ | 1818641160550219776 |
|---|---|
| author | Ahmed Elsanhoury Ahmed Elsanhoury Vivian Nelki Sebastian Kelle Sophie Van Linthout Sophie Van Linthout Carsten Tschöpe Carsten Tschöpe Carsten Tschöpe |
| author_facet | Ahmed Elsanhoury Ahmed Elsanhoury Vivian Nelki Sebastian Kelle Sophie Van Linthout Sophie Van Linthout Carsten Tschöpe Carsten Tschöpe Carsten Tschöpe |
| author_sort | Ahmed Elsanhoury |
| collection | DOAJ |
| description | Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with diverse etiologies and pathophysiological factors. Obesity and type 2 diabetes mellitus (T2DM), conditions that coexist frequently, induce a cluster of metabolic and non-metabolic signaling derangements which are in favor to induce inflammation, fibrosis, myocyte stiffness, all hallmarks of HFpEF. In contrast to other HFpEF risk factors, obesity and T2DM are often associated with the generation of enlarged epicardial adipose tissue (EAT). EAT acts as an endocrine tissue that may exacerbate myocardial inflammation and fibrosis via various paracrine and vasocrine signals. In addition, an abnormally large EAT poses mechanical stress on the heart via pericardial restrain. HFpEF patients with enlarged EAT may belong to a unique phenotype that can benefit from specific EAT-targeted interventions, including life-style modifications and pharmacologically via statins and fat modifying anti-diabetics drugs; like metformin, sodium-glucose cotransporter 2 inhibitors, or glucagon-like peptide-1 receptor agonists, respectively. |
| first_indexed | 2024-12-16T23:22:45Z |
| format | Article |
| id | doaj.art-ce6b2bba632c42a9851fea98d74ceddb |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-16T23:22:45Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-ce6b2bba632c42a9851fea98d74ceddb2022-12-21T22:12:08ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-09-01810.3389/fcvm.2021.720690720690Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF PhenotypeAhmed Elsanhoury0Ahmed Elsanhoury1Vivian Nelki2Sebastian Kelle3Sophie Van Linthout4Sophie Van Linthout5Carsten Tschöpe6Carsten Tschöpe7Carsten Tschöpe8Berlin Institute of Health at Charite (BIH), Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, GermanyGerman Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, GermanyDepartment of Cardiology, Campus Virchow Klinikum (CVK), Charité Universitätsmedizin Berlin, Berlin, GermanyDepartment of Internal Medicine/Cardiology, German Heart Center Berlin, Berlin, GermanyBerlin Institute of Health at Charite (BIH), Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, GermanyGerman Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, GermanyBerlin Institute of Health at Charite (BIH), Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, GermanyGerman Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, GermanyDepartment of Cardiology, Campus Virchow Klinikum (CVK), Charité Universitätsmedizin Berlin, Berlin, GermanyHeart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with diverse etiologies and pathophysiological factors. Obesity and type 2 diabetes mellitus (T2DM), conditions that coexist frequently, induce a cluster of metabolic and non-metabolic signaling derangements which are in favor to induce inflammation, fibrosis, myocyte stiffness, all hallmarks of HFpEF. In contrast to other HFpEF risk factors, obesity and T2DM are often associated with the generation of enlarged epicardial adipose tissue (EAT). EAT acts as an endocrine tissue that may exacerbate myocardial inflammation and fibrosis via various paracrine and vasocrine signals. In addition, an abnormally large EAT poses mechanical stress on the heart via pericardial restrain. HFpEF patients with enlarged EAT may belong to a unique phenotype that can benefit from specific EAT-targeted interventions, including life-style modifications and pharmacologically via statins and fat modifying anti-diabetics drugs; like metformin, sodium-glucose cotransporter 2 inhibitors, or glucagon-like peptide-1 receptor agonists, respectively.https://www.frontiersin.org/articles/10.3389/fcvm.2021.720690/fullheart failure with a preserved ejection fractionepicardiac adipose tissuediabetesobesitySGLT2inhibitor |
| spellingShingle | Ahmed Elsanhoury Ahmed Elsanhoury Vivian Nelki Sebastian Kelle Sophie Van Linthout Sophie Van Linthout Carsten Tschöpe Carsten Tschöpe Carsten Tschöpe Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype Frontiers in Cardiovascular Medicine heart failure with a preserved ejection fraction epicardiac adipose tissue diabetes obesity SGLT2 inhibitor |
| title | Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype |
| title_full | Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype |
| title_fullStr | Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype |
| title_full_unstemmed | Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype |
| title_short | Epicardial Fat Expansion in Diabetic and Obese Patients With Heart Failure and Preserved Ejection Fraction—A Specific HFpEF Phenotype |
| title_sort | epicardial fat expansion in diabetic and obese patients with heart failure and preserved ejection fraction a specific hfpef phenotype |
| topic | heart failure with a preserved ejection fraction epicardiac adipose tissue diabetes obesity SGLT2 inhibitor |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.720690/full |
| work_keys_str_mv | AT ahmedelsanhoury epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT ahmedelsanhoury epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT viviannelki epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT sebastiankelle epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT sophievanlinthout epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT sophievanlinthout epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT carstentschope epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT carstentschope epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype AT carstentschope epicardialfatexpansionindiabeticandobesepatientswithheartfailureandpreservedejectionfractionaspecifichfpefphenotype |