TGFB1 and endothelial dysfunction: It is well established that EAT secretes pro-inflammatory cytokines (such as IL-1β, IL-6, and TNF-α) and pro-fibrotic adipokines (such as TGF-β), which exert paracrine effects on adjacent cardiomyocytes, promoting oxidative stress, endothelial dysfunction, and fibrosis [24].