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Pathophysiology
Epicardial Adipose Tissue and Heart Failure, Friend or Foe?
Dong-Hyuk Cho, Seong-Mi Park
Diabetes Metab J. 2024;48(3):373-384.   Published online February 2, 2024
DOI: https://doi.org/10.4093/dmj.2023.0190
  • 1,104 View
  • 98 Download
  • 1 Crossref
AbstractAbstract PDFPubReader   ePub   
Heart failure (HF) management guidelines recommend individualized assessments based on HF phenotypes. Adiposity is a known risk factor for HF. Recently, there has been an increased interest in organ-specific adiposity, specifically the role of the epicardial adipose tissue (EAT), in HF risk. EAT is easily assessable through various imaging modalities and is anatomically and functionally connected to the myocardium. In pathological conditions, EAT secretes inflammatory cytokines, releases excessive fatty acids, and increases mechanical load on the myocardium, resulting in myocardial remodeling. EAT plays a pathophysiological role in characterizing both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). In HFrEF, EAT volume is reduced, reflecting an impaired metabolic reservoir, whereas in HFpEF, the amount of EAT is associated with worse biomarker and hemodynamic profiles, indicating increased EAT activity. Studies have examined the possibility of therapeutically targeting EAT, and recent studies using sodium glucose cotransporter 2 inhibitors have shown potential in reducing EAT volume. However, further research is required to determine the clinical implications of reducing EAT activity in patients with HF.

Citations

Citations to this article as recorded by  
  • New Mechanisms to Prevent Heart Failure with Preserved Ejection Fraction Using Glucagon-like Peptide-1 Receptor Agonism (GLP-1 RA) in Metabolic Syndrome and in Type 2 Diabetes: A Review
    Jorge E. Jalil, Luigi Gabrielli, María Paz Ocaranza, Paul MacNab, Rodrigo Fernández, Bruno Grassi, Paulina Jofré, Hugo Verdejo, Monica Acevedo, Samuel Cordova, Luis Sanhueza, Douglas Greig
    International Journal of Molecular Sciences.2024; 25(8): 4407.     CrossRef
Guideline/Fact Sheet
Evaluation and Management of Patients with Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon, The Committee of Clinical Practice Guidelines, Korean Diabetes Association and Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
Diabetes Metab J. 2023;47(1):10-26.   Published online January 26, 2023
DOI: https://doi.org/10.4093/dmj.2022.0420
  • 4,608 View
  • 419 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Diabetes mellitus is a major risk factor for the development of heart failure. Furthermore, the prognosis of heart failure is worse in patients with diabetes mellitus than in those without it. Therefore, early diagnosis and proper management of heart failure in patients with diabetes mellitus are important. This review discusses the current criteria for diagnosis and screening tools for heart failure and the currently recommended pharmacological therapies for heart failure. We also highlight the effects of anti-diabetic medications on heart failure.

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  • A Multicenter, Randomized, Open-Label Study to Compare the Effects of Gemigliptin Add-on or Escalation of Metformin Dose on Glycemic Control and Safety in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Treated with Metformin and SGLT-2 Inh
    Hae Jin Kim, Jung Hyun Noh, Min Kyong Moon, Sung Hee Choi, Seung-Hyun Ko, Eun-Jung Rhee, Kyu Yeon Hur, In-Kyung Jeong, Mark Yorek
    Journal of Diabetes Research.2024; 2024: 1.     CrossRef
  • Comparison of the effects of gemigliptin versus glimepiride on cardiac function in patients with type 2 diabetes uncontrolled with metformin: The gemi‐heart study
    Seung Min Chung, Jun Sung Moon, Jun Hwa Hong, In‐Chang Hwang, Soo Lim
    Diabetes, Obesity and Metabolism.2023; 25(8): 2181.     CrossRef
  • Optimization of guideline-directed medical treatment for heart failure patients with reduced ejection fraction
    Minjung Bak, Jin-Oh Choi
    The Korean Journal of Internal Medicine.2023; 38(5): 595.     CrossRef
Original Article
Metabolic Risk/Epidemiology
Longitudinal Change in Myocardial Function and Clinical Parameters in Middle-Aged Subjects: A 3-Year Follow-up Study
Dong-Hyuk Cho, Hyung Joon Joo, Mi-Na Kim, Hee-Dong Kim, Do-Sun Lim, Seong-Mi Park
Diabetes Metab J. 2021;45(5):719-729.   Published online June 15, 2021
DOI: https://doi.org/10.4093/dmj.2020.0132
  • 4,371 View
  • 108 Download
  • 2 Web of Science
  • 3 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   
Background
Metabolic syndrome (MetS) is closely associated with the aging process. However, changes in metabolic conditions and cardiac function that occur in middle aged population remain unclear. We evaluated longitudinal changes in metabolic parameters and cardiac function during a 3-year period in subjects with suspected MetS.
Methods
We studied 191 participants with suspected MetS at baseline and after 3 years. Anthropometric parameters, including waist circumference (WC), and metabolic parameters, including fasting blood glucose and lipid profile were measured. Conventional echocardiography with two-dimensional speckle tracking was performed.
Results
Mean age was 56.2±4.4 years, and there were 97 women (50.8%). Men had increased WC and triglycerides (TG) (WC 91.2±6.8 cm vs. 84.0±8.0 cm, P<0.001; TG 184.4±116.3 mg/dL vs. 128.2±53.6 mg/dL, P<0.001), and reduced global longitudinal strain (GLS) (–15.4%±2.1% vs. –17.1%±2.0%, P<0.001) compared to women. After 3.4 years, values of WC and TG did not change in men but increased in women (all P<0.05). The absolute value of left ventricular (LV) GLS did not change in men but was reduced in women (P=0.011). Change in TG was independently associated with worsening of LV GLS only in women (standardized β, –0.309; 95% confidence interval, –0.130 to –0.009; P=0.025).
Conclusion
In middle aged population, a vulnerable period for metabolic disturbance, cardiac remodeling tended to progress, which was prominent in women. Progression of adiposity and dyslipidemia after menopause may accelerate subclinical cardiac remodeling in middle-aged women. Lifestyle modification and medical interventions may help prevent further cardiac dysfunction in these subjects.

Citations

Citations to this article as recorded by  
  • Positive additive interaction effects of age, sex, obesity, and metabolic syndrome on left ventricular dysfunction
    Dan Zhou, Zhongwen Ye, Zhiqiang Nie, Chaolei Chen, Songyuan Luo, Mengqi Yan, Jiabin Wang, Yingqing Feng
    Journal of Diabetes.2024;[Epub]     CrossRef
  • Epicardial Adipose Tissue and Heart Failure, Friend or Foe?
    Dong-Hyuk Cho, Seong-Mi Park
    Diabetes & Metabolism Journal.2024; 48(3): 373.     CrossRef
  • Lung-Heart Outcomes and Mortality through the 2020 COVID-19 Pandemic in a Prospective Cohort of Breast Cancer Radiotherapy Patients
    Vincent Vinh-Hung, Olena Gorobets, Nele Adriaenssens, Hilde Van Parijs, Guy Storme, Dirk Verellen, Nam P. Nguyen, Nicolas Magne, Mark De Ridder
    Cancers.2022; 14(24): 6241.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal