TUMOR-NECROSIS-FACTOR-ALPHA AND THE FAILING HUMAN HEART

Tumor necrosis factor-alpha (TNF alpha) is a proinflammatory cytokine with negative inotropic effects. Recently, elevated levels of TNF alph a have been identified in patients with advanced heart failure. Althou gh the clinical significance of this finding is unclear at present, th ere is increasing evidence that this cytokine may play a primary patho physiologic role in the development and pathogenesis of heart failure in humans. Indeed, many of the clinical hallmarks of heart failure, in cluding left ventricular dysfunction, cardiomyopathy, and pulmonary ed ema can be explained by the known biological effects of TNF alpha in h umans. The present review will summarize recent evidence with regard t o the biological role for TNF alpha in the adult mammalian heart, as w ell as summarize the increasing body of clinical information that impl icates this cytokine in the pathophysiology of heart failure.