{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:24:18Z","timestamp":1787739858839,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL13955"],"award-info":[{"award-number":["R01HL13955"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL157261"],"award-info":[{"award-number":["R01HL157261"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Epicardial adipose tissue (EAT) is a metabolically active fat depot associated with cardiovascular risk and represents a modifiable imaging biomarker. Studies have shown that sodium\u2013glucose cotransporter\u20102 (SGLT2) inhibitors reduce EAT thickness in patients with type 2 diabetes mellitus (T2DM). However, it is unclear whether this is a direct effect on EAT or is secondary to concomitant weight loss.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To evaluate whether the SGLT2 inhibitor dapagliflozin reduces EAT independently of weight change in patients with T2DM without overt cardiovascular disease.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Secondary longitudinal imaging analysis of a prospective, randomized, placebo\u2010controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n \n Fifty\u2010six adults with T2DM without overt cardiovascular disease were randomized to dapagliflozin 10\u2009mg daily (\n N<\/jats:italic>\n \u2009=\u200927) or placebo (\n N<\/jats:italic>\n \u2009=\u200929) for 12\u2009months.\n <\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n Balanced steady\u2010state free precession cine at 3T.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n EAT thickness was quantified at eight predefined anatomical locations on MR images acquired at baseline and 12\u2009months. Body weight, body mass index (BMI), cardiovascular medication history, and C\u2010reactive protein were also assessed. The primary endpoint was change in average EAT thickness.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Between\u2010group comparisons were performed using the Mann\u2013Whitney\n U<\/jats:italic>\n test. Mediation and multivariable regression analyses assessed whether EAT change was independent of weight change. A\n p<\/jats:italic>\n value <\u20090.05 was considered significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Dapagliflozin significantly reduced average EAT thickness compared with placebo (median change \u22120.8\u2009mm [interquartile range (IQR): \u22121.3 to \u22120.4] vs. 0.1\u2009mm [IQR: \u22120.1 to 0.3]). Mediation analysis demonstrated a significant direct treatment effect not mediated by weight change [direct effect coefficient 0.81, 95% confidence interval (CI), 0.61\u20131.04] and a non\u2010significant indirect effect (indirect effect coefficient 0.15, 95% CI, \u22120.17 to 0.42,\n p<\/jats:italic>\n \u2009=\u20090.29). The association remained significant after adjustment for baseline EAT, baseline and change in body weight or BMI, age, sex, baseline use of any cardiovascular medication, and C\u2010reactive protein.\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n Dapagliflozin reduced EAT in patients with T2DM without overt cardiovascular disease, predominantly independent of weight change, supporting MRI\u2010derived EAT as a treatment\u2010responsive imaging biomarker.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 2.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 4.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n https:\/\/clinicaltrials.gov<\/jats:ext-link>\n ; Unique identifier: NCT03782259\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70526","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:59:45Z","timestamp":1787738385000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Dapagliflozin on\n MRI<\/scp>\n \u2010Derived Epicardial Adipose Tissue: Secondary Imaging Analysis of a Randomized Trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6358-8081","authenticated-orcid":false,"given":"Min Jae","family":"Cha","sequence":"first","affiliation":[{"name":"Department of Radiology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5423-4406","authenticated-orcid":false,"given":"Negar","family":"Firoozeh","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4021-5343","authenticated-orcid":false,"given":"Anna V.","family":"Naumova","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1408-989X","authenticated-orcid":false,"given":"Peter","family":"Muzi","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5438-4669","authenticated-orcid":false,"given":"Karen G.","family":"Ordovas","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1530-0255","authenticated-orcid":false,"given":"Dennis D.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4861-5659","authenticated-orcid":false,"given":"Daniel","family":"Isquith","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1644-7814","authenticated-orcid":false,"given":"Chuck","family":"Maynard","sequence":"additional","affiliation":[{"name":"Department of Health Systems and Population Health University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue\u2010Qiao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"issue":"9","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/s41569-022-00679-9","article-title":"Epicardial Adipose Tissue in Contemporary Cardiology","volume":"19","author":"Iacobellis G.","year":"2022","journal-title":"Nature Reviews. 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