Intramyocardial inflammation in DCM is demonstrated by a marked increased expression of cell adhesion molecules (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1), increased infiltration of macrophages and leukocytes and increased expression of inflammatory cytokines (interleukin (IL)-1β, IL-6, IL-18, tumor necrosis factor α (TNFα) and TGF-β1) [82]. Here, TNF is linked to familial dilated cardiomyopathy.