TNF and heart failure: It is well established that systemic inflammation and inflammatory mediators play an important role in the pathogenesis and progression of heart failure.17 The TNF-2 allele of the G-308A polymorphism, given that it is associated with increased inducible TNF-α production,9,10 could therefore contribute to the deleterious changes noted to occur in heart failure by enhancing TNF-α concentrations at either a circulating or a tissue level.