Inflammation is a prominent feature in the early stage of CHF and is marked by increased production of pro-inflammatory cytokines including tumor necrosis factor α, IL-1β, IL-18, MCP-1, MIP1α, CXCL1, and CXCL2, all of which promote inflammation, recruit macrophages, activate fibroblasts, and cause myocardial fibrosis51,52. The gene discussed is IL18; the disease is congestive heart failure.