Myocardial hypertrophy and remodeling that occur during heart failure seem also to be mediated, at least in part, by the ET system, through the activation of inflammatory and fibrotic processes and subsequent cytokine overexpression, such as tumor necrosis factor (TNF)-a, interleukin (IL)-1 and interleukin (IL)-6 [37,40]. Here, TNF is linked to heart failure.