This review explores the role of TNF-α, IL-6, and IL-1 in the acute decompensation of chronic heart failure (CHF), focusing on their mechanistic and clinical relevance. A systematic analysis of studies up to mid-2024 shows consistent cytokine elevation during decompensation, with IL-6 strongly linked to severity and mortality. These cytokines activate NF-κB, MAPK, and PI3K/Akt pathways, contributing to myocardial dysfunction and adverse remodeling. While IL-1 blockade shows therapeutic promise, anti-TNF strategies remain inconclusive. The findings highlight the need for targeted, phenotype-specific therapies and improved biomarker use in managing inflammation-driven CHF.

Chronic heart failure, acute decompensation, TNF-α, IL-6, IL-1β, cytokine signaling

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