ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
This article is part of the Research TopicDietary Inflammation, Metabolic Syndrome, and Cardiometabolic Health: Mechanisms, Inflammaging, and Translational InsightsView all 6 articles
Epicardial Adipose Tissue Volume Is Associated with Impaired Left Atrial Mechanics in Hypertensive Overweight/Obese Patients: The Potential Mediating Role of Insulin Resistance
Provisionally accepted
Shuang Yin
Xu ZhaoQing LiuTingting FuQiaobing SunYu PanMengxuan WangBing Wang
Minghui GongYan LuChongfu Jia
Yinong Jiang
Yan Liu*- First Affiliated Hospital, Dalian Medical University, Dalian, China
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Background: Epicardial adipose tissue (EAT) is implicated in cardiovascular disease, but its specific impact on left atrial (LA) mechanics in hypertensive overweight/obese patients remains unclear. We investigated the association between EAT volume (EATV) and LA dysfunction in this high-risk population. Methods: In this cross-sectional study, 264 hypertensive overweight/obese patients (body mass index ≥24 kg/m²) underwent coronary computed tomography angiography (CCTA) for EATV quantification. Participants were stratified into low-and high-EATV groups by the median value (72.67 cm³). LA strain analysis, including reservoir strain (LAs-s), conduit strain (LAs-e), booster strain (LAs-a), and LA stiffness index (LASI), were assessed by two-dimensional speckle tracking echocardiography. The triglyceride glucose-body mass index (TyG-BMI) was calculated to reflect the insulin resistance. Multivariable regression and mediation analyses evaluated associations between EATV and LA mechanics. Results: The high-EATV group had significantly higher TyG-BMI and longer hypertension duration. Despite comparable conventional echocardiographic parameters, this group demonstrated impaired LA mechanics, evidenced by reduced LAs-s, LAs-e, and LAs-a, alongside elevated LASI. EATV was inversely correlated with LA strains (LAs-s, LAs-e, LAs-a) but positively correlated with both TyG-BMI and LASI. After multivariable adjustment, EATV remained independently associated with LAs-s, LAsa, and LASI. Mediation analysis indicated that TyG-BMI explained 12.87% of the association between EATV and LAs-s, and 10.00% of the association between EATV and LASI. Conclusion: Increased EATV is independently associated with impaired LA mechanics in hypertensive overweight/obese patients. Insulin resistance, assessed by TyG-BMI, may partly explain these associations, linking epicardial adiposity to early atrial dysfunction.
Keywords: Epicardial adipose tissue volume, Hypertension, Left atrial strain, Overweight/obesity, Triglyceride glucose-body mass index
Received: 30 Dec 2025; Accepted: 04 Feb 2026.
Copyright: © 2026 Yin, Zhao, Liu, Fu, Sun, Pan, Wang, Wang, Gong, Lu, Jia, Jiang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Liu
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