TNF and hydrops fetalis: In a small prospective randomized clinical trial with HFrEF patients (LV < 45%) treated for 12 weeks, it resulted in a significant reduction of TNF, IL-6, and MCP-1 levels; upregulation of anti-inflammatory cytokines (IL-10 and soluble IL-1 receptor antagonist); and improvement in HF classification, 6-min walk test distance, and QoL.