Fig. 1. Increasing visceral obesity causes inflammatory responses and metabolic dysregulation in fat and liver tissue. This condition involves infiltration of monocytes and macrophages and subsequent secretion of pro-inflammatory adipokines and elevated release of free fatty acids, leading to systemic inflammation, which promotes insulin resistance in several organs, including the heart. In addition, an elevated supply of lipids (free and esterified fatty acids) exceeds the fatty acid oxidation capacity and causes lipotoxicity in the myocardium, eventually leading to cardiac dysfunction.