Under stressful conditions, namely excessive hemodynamic stimulation and mechanical stress, cytokines promote and sustain an unbalanced status within the myocardium, with enhanced production of TNF-α accompanied by a simultaneous reduction of IL-6 levels and insulin-like growth factor (IGF)-1, that may critically contribute to the development of the HF phenotype [62]. This evidence concerns the gene IGF1 and hydrops fetalis.