{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T06:07:37Z","timestamp":1779084457609,"version":"3.51.4"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epicardial adipose tissue (EAT) has been implicated in adverse cardiac remodeling after acute myocardial infarction (AMI), but its imaging-based characterization remains limited. This study was designed to develop and validate EAT radiomics\u2013based models for predicting ventricular remodeling (VR) and major adverse cardiovascular events (MACE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A single-center prospective cohort study enrolled 206 AMI patients at the Second Affiliated Hospital of Anhui Medical University between January 2022 and June 2023. EAT radiomics features were extracted from cardiac CT using Pyradiomics, and predictive models were constructed with machine learning algorithms. Statistical analyses were performed using R, Python, and SPSS, with significance set at P &amp;lt; 0.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 12-month follow-up, 29.6% developed VR and 19.9% experienced MACE. EAT volume was independently associated with both outcomes (P &amp;lt; 0.001). Radiomics-based Model 2 showed superior predictive performance compared with Model 1, with higher AUC and C-index values across validation folds. Experimental studies demonstrated that EAT aggravated myocardial injury, fibrosis, and apoptosis, which were partially attenuated by IL-6 neutralization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integrating EAT radiomics with clinical parameters improves prediction of VR and MACE after AMI and is supported by experimental evidence linking EAT to post-infarction remodeling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1781007","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:41:25Z","timestamp":1779082885000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epicardial adipose tissue radiomics predicts VR and MACE after AMI: a prospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Zeyan","family":"Liu","sequence":"first","affiliation":[{"name":"Emergency Internal Medicine Department, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Chest Pain Center (CPC), The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanfang","family":"Yang","sequence":"additional","affiliation":[{"name":"Imaging Medicine Department, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodong","family":"Pan","sequence":"additional","affiliation":[{"name":"Emergency Internal Medicine Department, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]},{"name":"Chest Pain Center (CPC), The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Yang","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine Department II, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1186\/s12872-023-03231-w","article-title":"The global prevalence of myocardial infarction: a systematic review and meta-analysis","volume":"23","author":"Salari","year":"2023","journal-title":"BMC Cardiovasc Disord"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.123.029971","article-title":"Acute myocardial infarction: etiologies and mimickers in young patients","volume":"12","author":"Krittanawong","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.0662","article-title":"Trends in 10-year outcomes among Medicare beneficiaries who survived an acute myocardial infarction","volume":"7","author":"Wang","year":"2022","journal-title":"JAMA Cardiol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/ijms262210964","article-title":"Left ventricular remodeling after myocardial infarction-pathophysiology, diagnostic approach and management during cardiac rehabilitation","volume":"26","author":"Marcos-Garc\u00e9s","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5875-3","article-title":"Prognosis-based definition of left ventricular remodeling after ST-elevation myocardial infarction","volume":"29","author":"Reindl","year":"2019","journal-title":"Eur Radiol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.61891","article-title":"Effects of renal impairment on cardiac remodeling and clinical outcomes after myocardial infarction","volume":"18","author":"Chiang","year":"2021","journal-title":"Int J Med Sci"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/clc.24157","article-title":"Comparison of machine-learning models for the prediction of 1-year adverse outcomes of patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction","volume":"47","author":"Tofighi","year":"2024","journal-title":"Clin Cardiol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac223","article-title":"Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies","volume":"43","author":"Frantz","year":"2022","journal-title":"Eur Heart J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"20190028","DOI":"10.1098\/rsif.2019.0028","article-title":"Epicardial prestrained confinement and residual stresses: a newly observed heart ventricle confinement interface","volume":"16","author":"Shi","year":"2019","journal-title":"J R Soc Interface"},{"key":"B10","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1038\/s41569-022-00679-9","article-title":"Epicardial adipose tissue in contemporary cardiology","volume":"19","author":"Iacobellis","year":"2022","journal-title":"Nat Rev Cardiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"397","DOI":"10.3390\/diagnostics11030397","article-title":"Epicardial adiposity in relation to metabolic abnormality, circulating adipocyte FABP, and preserved ejection fraction heart failure","volume":"11","author":"Lin","year":"2021","journal-title":"Diagnostics (Basel)"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.509","article-title":"Epicardial adipose tissue may mediate deleterious effects of obesity and inflammation on the myocardium","volume":"71","author":"Packer","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.07.031","article-title":"Threshold for the upper normal limit of indexed epicardial fat volume: derivation in a healthy population and validation in an outcome-based study","volume":"108","author":"Shmilovich","year":"2011","journal-title":"Am J Cardiol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2024.132697","article-title":"Prognostic utility of dynamic changes in epicardial adipose tissue in patients undergoing transcatheter aortic valve replacement","volume":"419","author":"Lin","year":"2025","journal-title":"Int J Cardiol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeac092","article-title":"Decoding the radiomic and proteomic phenotype of epicardial adipose tissue associated with adverse left atrial remodelling and post-operative atrial fibrillation in aortic stenosis","volume":"23","author":"Mancio","year":"2022","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B16","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.tcm.2024.06.003","article-title":"Enhancing cardiovascular risk stratification: radiomics of coronary plaque and perivascular adipose tissue - current insights and future perspectives","volume":"35","author":"Corti","year":"2025","journal-title":"Trends Cardiovasc Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu207","article-title":"Towards better clinical prediction models: seven steps for development and an ABCD for validation","volume":"35","author":"Steyerberg","year":"2014","journal-title":"Eur Heart J"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"72","author":"Thygesen","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.5114\/aic.2018.79867","article-title":"Left ventricular reverse remodeling in patients with anterior wall ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention","volume":"14","author":"Grabka","year":"2018","journal-title":"Postepy Kardiol Interwencyjnej"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.119.014205","article-title":"Estimating myocardial infarction size with a simple electrocardiographic marker score","volume":"9","author":"Lee","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2276","DOI":"10.1038\/s41598-022-06351-z","article-title":"Deep learning segmentation and quantification method for assessing epicardial adipose tissue in CT calcium score scans","volume":"12","author":"Hoori","year":"2022","journal-title":"Sci Rep"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e15738","article-title":"The role of epicardial and pericoronary adipose tissue radiomics in identifying patients with non-ST-segment elevation myocardial infarction from unstable angina","volume":"9","author":"Wang","year":"2023","journal-title":"Heliyon"},{"key":"B23","doi-asserted-by":"publisher","first-page":"20195","DOI":"10.1038\/s41598-025-06206-3","article-title":"Nano astaxanthin ameliorates myocardial infarction in rats through autophagy","volume":"15","author":"Radwan","year":"2025","journal-title":"Sci Rep"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232113450","article-title":"Microbiota alterations in patients with autoimmune thyroid diseases: a systematic review","volume":"23","author":"Sawicka-Gutaj","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-021-01865-4","article-title":"The impact of epicardial adipose tissue in patients with acute myocardial infarction","volume":"110","author":"Fisser","year":"2021","journal-title":"Clin Res Cardiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1186\/s12933-025-02720-w","article-title":"Epicardial adipose tissue and heterogeneity parameters combined with inflammatory cells to predict the value of heart failure with preserved ejection fraction patients post myocardial infarction","volume":"24","author":"Song","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-024-02479-2","article-title":"Chest-CT-based radiomics feature of epicardial adipose tissue for screening coronary atherosclerosis","volume":"40","author":"Wei","year":"2025","journal-title":"Heart Vessels"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110106","article-title":"Characterisation of quantitative imaging biomarkers for inflammatory and fibrotic radiation-induced lung injuries using preclinical radiomics","volume":"192","author":"Brown","year":"2024","journal-title":"Radiotherapy Oncol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-024-07637-2","article-title":"Epicardial adipocytes in cardiac pathology and healing","volume":"39","author":"La","year":"2024","journal-title":"Cardiovasc Drugs Ther"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2023.100657","article-title":"Uncovering the role of epicardial adipose tissue in heart failure with preserved ejection fraction","volume":"2","author":"Goldman","year":"2023","journal-title":"JACC: Adv"},{"key":"B31","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/s12933-024-02298-9","article-title":"Sodium-glucose cotransporter 2 inhibitors induce anti-inflammatory and anti-ferroptotic shift in epicardial adipose tissue of subjects with severe heart failure","volume":"23","author":"Kasperova","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-024-10450-6","article-title":"GLP-1 receptor agonists as promising anti-inflammatory agents in heart failure with preserved ejection fraction","volume":"30","author":"Bonfioli","year":"2025","journal-title":"Heart Failure Rev"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2024.04.001","article-title":"Epicardial adipose tissue and major adverse cardiovascular events in myocardial infarction patients with and without diabetes","volume":"31","author":"Huang","year":"2024","journal-title":"Acad Radiol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1781007\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:41:26Z","timestamp":1779082886000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1781007\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":33,"alternative-id":["10.3389\/fendo.2026.1781007"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1781007","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"article-number":"1781007"}}