{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:57:21Z","timestamp":1792504641065,"version":"4.5.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Coronary microvascular dysfunction (CMD), which mimics symptoms of obstructive coronary artery disease, has significant prognostic implications. While epicardial adipose tissue normally has a protective role, increased epicardial adipose tissue is associated with inflammation and may contribute to CMD. However, a direct correlation remains unclear. We aimed to investigate this association.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The CMDR (Coronary Microvascular Disease Registry) is a prospective, 2\u2010center registry that is enrolling patients with angina and nonobstructive coronary artery disease who underwent invasive hemodynamic assessment of the coronary microvasculature. Patients with chest computed tomography within 1\u2009year of CMD evaluation were included. We measured epicardial fat volume (EFV) and calculated the EFV index. Logistic regression analysis was used to investigate the association between EFV and EFV index to CMD. Our study included 130 CMDR patients with associated chest CT; 35 were diagnosed with CMD. The CMD\u2010negative patients were younger than the CMD\u2010positive patients (58.52\u00b111.97 versus 63.37\u00b19.56\u2009years;\n              <jats:italic>P<\/jats:italic>\n              =0.033), with numerically fewer women (64.2% versus 74.3%;\n              <jats:italic>P<\/jats:italic>\n              =0.279). Univariate regression analysis demonstrated a statistically significant association between EFV index and CMD diagnosis (odds ratio, 1.037 [95% CI, 1.014\u20131.063];\n              <jats:italic>P<\/jats:italic>\n              =0.003), while no significance was observed for EFV (odds ratio, 1.006 [95% CI, 0.995\u20131.017];\n              <jats:italic>P<\/jats:italic>\n              =0.292).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our results suggest a strong association between EFV index (a significant risk factor) and the presence of CMD. Future studies involving larger cohorts are needed to confirm the association of epicardial adipose tissue with CMD and investigate therapeutic targets to prevent CMD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; unique identifier: NCT05960474.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.038484","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T10:11:46Z","timestamp":1738577506000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Epicardial Fat Tissue: A Potential Marker for Coronary Microvascular Dysfunction"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-8483","authenticated-orcid":false,"given":"Waiel","family":"Abusnina","sequence":"first","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3294-5968","authenticated-orcid":false,"given":"Ilan","family":"Merdler","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Cellamare","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0602-2684","authenticated-orcid":false,"given":"Kalyan 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