Tumor necrosis factor‐α and the failing human heart–TNFα and heart failure

Tumor necrosis factor‐alpha (TNFα) is a proin‐flammatory cytokine with negative inotropic effects. Recently, elevated levels of TNFα have been identified in patients with advanced heart failure. Although the clinical significance of this finding is unclear at present, there is increasing evidence that this cytokine may play a primary pathophysiologic role in the development and pathogenesis of heart failure in humans. Indeed, many of the clinical hallmarks of heart failure, including left ventricular dysfunction, cardiomyopathy, and pulmonary edema can be explained by the known biological effects of TNFα in humans. The present review will summarize recent evidence with regard to the biological role for TNFα in the adult mammalian heart, as well as summarize the increasing body of clinical information that implicates this cytokine in the pathophysiology of heart failure.