Tumor necrosis factor-alpha in chronic heart failure. Clinical manifestations and therapeutic options

Background: Chronic heart failure (CHF) may be seen as a multi-system disor der with its origin in the heart but including many extracardiac manifestat ions. Immunological abnormalities are recognized in this context, in partic ular, changes in the expression of mediators of the innate immune response. Importance of TNF: Higher levels of the pro-inflammatory cytokine tumor ne crosis factor-alpha (TNF) are found in the circulation and in the myocardiu m of patients with chronic heart failure than in controls. TNF has been imp licated in a number of pathophysiological processes that are thought to be important to the progression of chronic heart failure. Therapies directed a gainst this cytokine might therefore represent anovel approach to heart fai lure management.