TNF and Sepsis: Some researchers believe that the main role in damage to cardiomyocytes in sepsis is played by inflammatory mediators, such as tumor necrosis factor-alpha (TNF-ɑ), interleukins (IL-1, IL-6), and bacterial exo- and endo-toxins, which have a direct cytotoxic effect on cardiomyocytes [92,93,94].