Figure 1.

Flowchart of 92 Consecutive Patients Who Underwent Open Heart Surgery and Were Enrolled in the Multicenter Cohort

SGLT2 expression levels in human EAT and preadipocytes/adipocytes were evaluated in 25 nondiabetic patients. In vitro incubation studies or coculture experiments using human adipocytes/preadipocytes and human induced-pluripotent stem cell–derived cardiomyocytes included the same nondiabetic 25 patients to confirm the pure effect of SGLT2 inhibitors on preadipocytes/adipocytes (study 1). A cohort-wide association study to clinically validate the effect of SGLT2 inhibitors on EAT included 29 diabetic patients treated with SGLT2 inhibitors or other antidiabetic drugs (study 2). In addition, the gene expression levels of inflammatory adipocytokines were statistically compared using samples from 19 patients with AF and 19 patients without AF (study 3). EAT = epicardial adipose tissue; SGLT2 = sodium-glucose cotransporter.