TNF and Myocardial fibrosis: Sustained increases in the levels of pro-inflammatory cytokines and chemokines, such as tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1) and interleukin-6 (IL-6), could directly and indirectly cause cardiac tissue injury, such as myocardial fibrosis, necrosis and apoptosis, which inevitably leads to cardiac diastolic and subsequent systolic dysfunction [150,151].