SGLT2i and GLP-1 RAs most consistently reduce epicardial adipose tissue thickness and shift it from inflammatory to metabolically active phenotype through multiple molecular mechanisms.
Heart fat remodeledGLP-1 and SGLT2 drugs transform inflammatory epicardial fat into metabolically active tissue, potentially protecting the heart at its surface
What the researchers found
SGLT2i and GLP-1 RAs most consistently reduce EAT thickness, suppress inflammation, enhance insulin sensitivity, and promote adipocyte browning/oxidative metabolism, shifting EAT toward a less pathological phenotype.
Why it matters
Epicardial fat directly contacts the heart and coronary arteries. Modifying this fat depot with drugs could prevent heart disease at its source.
How the study worked
Review of pharmacological interventions affecting epicardial adipose tissue, covering molecular mechanisms from in vitro and in vivo studies.
What this study cannot tell us
Many mechanisms from animal studies. EAT-specific drug effects hard to separate from systemic effects. Measurement methods vary.
How to read the evidence
Review of molecular mechanisms from in vitro, in vivo, and clinical imaging studies.
When this study was published
Published in 2025.
The bigger picture
EAT is emerging as a therapeutic target in cardiovascular prevention, with GLP-1 drugs offering the most promising depot-specific effects.
Questions still open
- Should EAT thickness guide cardiovascular drug selection?
- Do GLP-1 drugs directly act on epicardial adipocytes?
- Could EAT imaging become a routine cardiovascular risk marker?
Common questions
What is epicardial adipose tissue?
Can drugs change heart fat?
Read the original research
Heart matters: How glucose- and lipid-modulating drugs remodel epicardial adipose tissue accumulation, inflammatory patterns and browning.
Diabetes, obesity & metabolism, 28(2), 878-894
Citation
Heuboeck, Elisabeth; Bhogal, Charnkamal Singh; Mandl, Markus. (2026). Heart matters: How glucose- and lipid-modulating drugs remodel epicardial adipose tissue accumulation, inflammatory patterns and browning.. Diabetes, obesity & metabolism, 28(2), 878-894. https://doi.org/10.1111/dom.70324