In addition, the process of erythrocyte maturation and hemoglobin synthesis is disrupted in chronic heart failure, the level of some pro-inflammatory cytokines increases, namely tumor necrosis factor-alpha (TNF-α), which inhibits normal hematopoiesis, and the reception and synthesis of erythropoietin (EPO) is also disrupted [25]. This evidence concerns the gene EPO and congestive heart failure.