TNF and chronic obstructive pulmonary disease: Patients with ILAV > 36.5 ml/m2 exhibited worsening diastolic and systolic function, as indicated by mitral E wave peak velocity in the rapid filling phase/E' velocity of displacement of the septal or lateral mitral annulus in the rapid filling phase (E/E') (p = 0.02) and left ventricle ejection fraction (p = 0.01), along with elevated levels of tumor necrosis factor alpha (p = 0.05) and NT-proBNP (p = 0.03).<h4>Conclusion</h4>ILAV may be a reliable marker for predicting unfavorable outcomes in patients with COPD.