TNF and heart failure: TNF is an important and pleiotropic cytokine which is also involved in the pathogenesis of inflammation in RA.10 Basic science research showed that hypertension overexpressed TNF which played a vital role in the hypertension's occurrence and development,11 and chronic infusion of TNF is adequate to mimic some aspects of heart failure (HF), including progressive ventricular dysfunction and cardiomyocyte hypertrophy; some of which can be reversed by treatment of anti-TNF agents.12,13