@article{QIMS155253,
author = {Jia-Shen Jiang and Lei Li and Xiao-Yu Wang and Xi-Wu Ruan and Kou-Long Zheng and Dan Gao and Sheng Huang and Tian-Le Wang and Rong-Xing Qi},
title = {Epicardial adipose tissue density, myocardial fibrosis, and heart failure with preserved ejection fraction in postmenopausal women: a mediation analysis},
journal = {Quantitative Imaging in Medicine and Surgery},
volume = {16},
number = {7},
year = {2026},
keywords = {},
abstract = {Background: Heart failure with preserved ejection fraction (HFpEF) predominantly affects postmenopausal women, but its underlying mechanisms remain unclear. Epicardial adipose tissue (EAT), a metabolically active fat depot adjacent to the myocardium, has been implicated in HFpEF. This study aimed to evaluate the associations of EAT volume and density with HFpEF in postmenopausal women and to determine whether myocardial fibrosis mediates this relationship.Methods: In this retrospective cross-sectional study, we included 70 postmenopausal women with HFpEF and 70 age-matched controls (±3 years) who underwent cardiac computed tomography (CT). EAT volume and density were quantified from coronary artery calcium scoring images. Myocardial extracellular volume (ECV), derived from dual-energy CT, was used to quantify myocardial fibrosis. Multivariable regression analyses and mediation analyses were performed to evaluate the associations between EAT characteristics, ECV, and HFpEF.Results: EAT volume index, density, and ECV were significantly higher in the HFpEF group than in controls (all P},
issn = {2223-4306}, url = {https://qims.amegroups.org/article/view/155253}
}