TNF and Myocardial fibrosis: Proinflammatory cytokines such as tumor necrosis factor (TNF-α), interleukin 1β (IL-1β), and interleukin 6 (IL-6) can inhibit myocardial contraction, promote myocardial fibrosis, and increase collagen synthesis in pathological cardiac hypertrophy [14, 25, 26].