TNF and heart failure: Although circulating and cardiac TNF-α concentrations are lower in healthy individuals, higher TNF-α concentrations alter myocardial function, primarily in ischemia/reperfusion, remodeling, and heart failure (Bryant et al., 1998; Sivasubramanian et al., 2001; Heusch et al., 2009; Kleinbongard et al., 2011).