TNF and heart failure: Elamipretide not only normalizes plasma levels of tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) but also significantly improves mitochondrial function, including the restoration of state-3 respiration, mitochondrial membrane potential (Δψm), ATP synthesis rate, and ATP/ADP ratio.Studies have also found that in both dogs and humans with heart failure (HF), mitochondrial dynamics in the left ventricular myocardium are impaired, with disrupted mitochondrial biogenesis, imbalances in fission and fusion mechanisms, and downregulation of mitofusins.