TNF and heart failure: Patients with heart failure have elevated plasma concentrations of the pro-inflammatory cytokine TNF-α.1 TNF-α may mediate a variety of detrimental effects on the heart, including cardiac dilatation, a decreased cardiac contractility2 and alterations in the properties of the extracellular matrix.3 Despite evidence in favour of a pathophysiological role of TNF-α in heart failure, therapeutic strategies designed to target TNF-α effects in heart failure have produced conflicting outcomes.4-6