However, in the case of systemic inflammation caused by metabolic disorders (such as NAFLD) and the accompanying accumulation of EAT, the secretion of adiponectin is decreased, while EAT releases a large number of inflammatory mediators (such as IL-6, IL-8, TNF-a, and leptin), aggravating the inflammatory environment and adversely affecting the myocardial structure and electrical remodeling (29, 30). Here, TNF is linked to metabolic dysfunction-associated steatotic liver disease.