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Open research questions in Cardiovascular Disease and Adiposity

33 unresolved questions extracted from the limitations and future-work sections of 212 Cardiovascular Disease and Adiposity papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Whether imaging-derived adipose tissue depots capture specific cardiometabolic pathways underlying HF risk beyond conventional anthropometric measures remains uncertain.

    MRI-Derived Fat Depots and Cardiometabolic Pathways Underlying Heart Failure Risk: A Mendelian Randomization Study · 2026 · DOI

  • The molecular mechanisms driving sex- and gender-spe- cific CKM syndrome progression remain incompletely understood, particularly the pathophysiological transi- tion from subclinical to overt CVD.

    Challenges and knowledge gaps in sex differences in cardio–kidney–metabolic syndrome across the lifespan · 2026 · DOI

  • The underlying mechanism remains unclear, but prolonged hypoxia may activate the sterol-regulating ele- ment binding protein-1 pathway, leading to hyperlipid- emia [14].

    Quantitative CT analysis of intra-abdominal fat, subcutaneous fat, and bone mineral density disparities in individuals with obesity and obstructive sleep apnea compared to those with obesity alone · 2026 · DOI

  • This study involved a small sample size, and a higher proportion of female patients was observed, potentially introducing data bias. Further data collection is deemed Feng et al.

    Quantitative CT analysis of intra-abdominal fat, subcutaneous fat, and bone mineral density disparities in individuals with obesity and obstructive sleep apnea compared to those with obesity alone · 2026 · DOI

  • Limitations This meta-analysis has should be considered when interpreting the findings. First, most studies had relatively short follow-up periods (≤6 months), which may not fully capture the long-term impact of SGLT2 inhibitors on adipose tissue remodelling. Second, whilst there was some heterogeneity identified in the pooled estimates, there were inherent differences in imaging techniques across studies to assess EAT volume, affecting spatial resolution, reproducibility and operator dependency.

    SGLT2 inhibitors are associated with reductions in epicardial adipose tissue volume and thickness: a meta-analysis · 2026 · DOI

  • At the same time, the evidence base remains limited by the short duration of follow-up, small sample sizes, lack of standardization of EAT assessment, and the scarcity of interventional studies in patients at the highest cardiovascular risk, as well as by the absence of long-term data on the impact, of EAT reduction on hard clinical endpoints [7,10,12,13,20,21,22].

    Physical Activity as a Modulator of Epicardial Adipose Tissue Dysfunction and Adipokine Profile in Obesity: Cardioprotective Mechanisms and Clinical Implications. A Literature Review · 2026 · DOI

  • Ours has some limitations that should be acknowledged. The most notable is the relatively small sample size com- pared to similar studies. Several factors contributed to this. First, our strict inclusion criteria and the require- ment for both carotid and abdominal ultrasound within the same clinical session limited the sample pool. Addi- tionally, our emphasis on minimizing variability by hav- ing all imaging performed by a single radiologist and our focus on real-world clinical imaging further contributed to the smaller sample size. Furthermore, the scope of our analysis did not include an adjustment for several potential confounders, such as metabolic syndrome, BMI, smoking status. We acknowl- edge that these factors may influence the interpretation Zeinalkhani et al. Egypt J Radiol Nucl Med (2026) 57:70 Page 7 of 8 of our results. In fact, the contrast between our findings and those of some previous studies highlights a critical point: the relationship between prerenal fat thickness (PRFT) and cardiac risk is clearly complex. Therefore, more methodologically robust studies, which account for these diverse variables in larger populations, are urgently needed to truly scrutinize this relationship before PRFT can be validated as an independent risk factor.

    Associations of prerenal fat, carotid intima–media thickness, and plaque formation in cardiovascular health—a cross-sectional analysis · 2026 · DOI

  • Although previous studies have defined Rho-associated, coiled-coil-containing protein kinase 2 (ROCK2) as an inducer of vascular inflammation, a direct role for the endothelium-adipocyte network in physiological and pathophysiological states has not been previously established.

    111-OR: Vascular Endothelium-Specific ROCK2 Deficiency Inhibits the Progression of Obesity via Adipocyte Browning · 2024 · DOI

  • However, the possible significance of dapagliflozin in the reversal of structural and functional changes in the arteries in patients with type 2 DM and obesity has not been studied enough.

    Effect of dapagliflozin on the structural and functional properties of arterial vessels in patients with type 2 diabetes mellitus in combination with obesity · 2020 · DOI

  • However, the comparative performance of VAT‐related clinical surrogates remains poorly characterised.

    Predictive Performance of Seven Clinical Surrogates of Visceral Adipose Tissue for Cardiovascular Mortality: A Sub‐Analysis of 102 385 Adults From the Mexico City Prospective Study · 2026 · DOI

  • Thoracic aortic perivascular adipose tissue (tPVAT) is dysfunctional in lupus and exacerbates endothelial dysfunction, yet the molecular basis of this dysfunction remains poorly defined.

    Immunometabolic Remodeling of Perivascular Adipose Tissue in Murine Lupus: Implications for Lupus Vasculopathy · 2026 · DOI

  • to the course of CVDs. EAT is a distinct adipose depot that modulates several pathophysiological…

    Epicardial adipose tissue in cardiovascular diseases: a potential therapeutic target · 2026 · DOI

  • However, when compared with other organs, relatively little is known about the molecular machinery that directly governs the crosstalk system in adipose tissue.

    111-OR: Vascular Endothelium-Specific ROCK2 Deficiency Inhibits the Progression of Obesity via Adipocyte Browning · 2024 · DOI

  • Whether visceral adiposity by itself in patients with asthma is responsible for elevated risk of pre-atherosclerosis remains uncertain; the previous study population may not have been sufficient.

    Investigation of the Relationship between Asthma and Visceral Obesity by Epicardial Fat Thickness Measurement · 2019 · DOI

  • The mechanisms linking sarcoidosis and atherosclerosis pathophysiology are mentioned as similar but not explicitly detailed or mechanistically explored in the excerpt.

    Evaluation of subclinical atherosclerosis with carotid intima media and epicardial fat thickness in patients with sarcoidosis · 2019 · DOI

  • Patients who had previously been diagnosed but were receiving treatment for sarcoidosis were excluded from the study, limiting the generalizability of findings to untreated or newly diagnosed populations only.

    Evaluation of subclinical atherosclerosis with carotid intima media and epicardial fat thickness in patients with sarcoidosis · 2019 · DOI

  • Due to its asymmetrical distribution, the relation between location-specific EAT measurements and coronary atherosclerosis remains unclear.

    The relationship between location-specific epicardial adipose tissue volume and coronary atherosclerotic plaque burden in type 2 diabetic patients · 2016 · DOI

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33 open questions have been extracted from the limitations and future-work passages of 212 Cardiovascular Disease and Adiposity papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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