Since the recognition by Levine et al. (1990) of elevated TNF-α in CHF patients, there has been a growing body of evidence on the association of a myriad of cytokines and chemokines with HFrEF but more recently this has also been demonstrated in the entire clinical spectrum of HF like HFpEF and even in AHF and CS (Mann, 2015). Here, TNF is linked to hydrops fetalis.