A study published in JACC found that intramuscular fat infiltration in the thighs was associated with a higher risk of developing heart failure. The observation opened several new avenues of research aimed at modifying intramuscular fat levels as a strategy to reduce the risk of developing heart failure. 

Based on general physiology, it is already known that the fat deposition around and within non-adipose tissues such as skeletal muscle, is also a known risk factor for cardiovascular disease, independent of adiposity. However, the impact of peripheral skeletal muscle fat deposition on heart failure risk is not as well studied. Hence, the researchers conducted the current study to characterize the association of both intermuscular and intramuscular fat deposition with heart failure risk in a large cohort of older adults. They found that there are differences in the biology of intermuscular and intramuscular fat deposition, and that excess intramuscular fat deposition is a result of dysregulated lipid metabolism and is associated with insulin resistance, inflammation, and muscle-wasting conditions.

Dr. Salvatore Carbone, Ph.D., Virginia Commonwealth University, Richmond added that SGLT2 inhibitors, drugs used in the treatment of diabetes that has shown favorable clinical results in preventing heart failure in individuals at risk, can also improve the composition of intramuscular adipose tissue by reducing its content of saturated fatty acids and increasing the content of monosaturated fatty acids. 

(Source: https://www.medscape.com/viewarticle/976400?src=#vp_2 )