Lutein, a major carotenoid, showed a protective effect in a cardiac failure rat model by improving cardiac morphology, antioxidant status via positively regulating the Nrf2/HO-1 signaling pathway, and reducing inflammatory markers (IL-1β, IL-6, TNF-α, NF-κB, p65) and apoptotic markers (caspase-3 and caspase-9) [221]. Here, TNF is linked to heart failure.