Visceral adipose tissue and the female heart: mechanisms and implications

Heart failure with preserved ejection fraction (HFpEF) is an increasingly prevalent clinical challenge, particularly among aging and postmenopausal women. Emerging evidence highlights a significant role of adipose tissue, especially adipose tissue surrounding the heart, in the pathogenesis of HFpEF. Visceral fat depots function as endocrine and inflammatory organs. Coupled with hormonal changes during menopause, adipose tissue contributes to cellular senescence and myocardial dysfunction. This brief review summarizes the mechanistic links among adipose tissue, sex hormones, and depot-specific inflammation in HFpEF, and underscores potential targets for future research and therapeutic intervention.