The importance of TNF-α in HF has experimentally been shown in transgenic mice where chronic cardiomyocyte overexpression of TNF-α resulted in the development of dilated cardiomyopathy with ventricular hypertrophy, ventricular dilatation, interstitial infiltrates, interstitial fibrosis, rare myocyte apoptosis, diminished ejection fraction, attenuation of β1-adrenergic responsiveness, and expression of atrial natriuretic peptide (ANP) in the ventricle [43]. This evidence concerns the gene NPPA and hydrops fetalis.