TO THE EDITOR: We read with great interest and excitement the recently published work of Burgeiro et al. (3) about the impairment of glucose uptake and lipid metabolism in epicardial adipose tissue from heart failure patients with or without diabetes. The authors stated the difference between basal and insulin conditions in glucose uptake within epicardial compared with subcutaneous adipocytes....

A 62-year-old man with no history of cardiac disease was referred because of exertional dyspnea. His body mass index was elevated at 29 kg/m, and a large cutaneous lipoma was present on his abdominal wall. Transthoracic echocardiography was performed and initially reported to demonstrate a moderate-sized global pericardial effusion (Figure 1 and Movies 1 and 2). Consideration was given to peric...