Inflammatory cytokines contribute to the progression of chronic heart failure (CHF), and they are related to patients’ prognosis. Advanced CHF can be considered a state of chronic (low-grade) inflammation, and there are many reasons to think that anticytokine (and particularly anti–tumor necrosis factor-a [TNF-a]) therapy could be successful in these patients. If anti–TNF-a therapies could be shown to be successful in CHF patients, the etiological link between TNF-a and CHF deterioration could finally be considered proven. Many questions remain to be answered before we can make a final decision about the use of anticytokine treatment in patients with CHF. In my opinion, it is very likely that one day in the not so distant future we will routinely use anticytokine-directed therapies in CHF patients. Whatever the outcome, we are experiencing the beginning of a new era of therapeutic research in heart failure...