TNF and Obesity: Obesity, diabetes, and hypertension drive visceral adipose tissue (VAT) and epicardial adipose tissue (EAT) expansion, which secretes proinflammatory cytokines [e.g., Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α)] and profibrotic mediators, ultimately inducing myocardial stiffness augmentation and diastolic impairment (12).