Figure 1.

Competing theories. Several theories to explain the cause(s) of inflammatory immune activation in CHF have been suggested. These theories may in fact complement each other. The myocardium itself is able to release pro-inflammatory cytokines, which is augmented by adrenergic stimulation. Myocardial tissue injury—for example, myocardial infarction, bacterial translocation, and peripheral tissue hypoxia—may lead to mononuclear cell activation, which eventually leads to pro-inflammatory cytokine activation. See text for details. LPS, lipopolysaccharide; LV, left ventricle; RV, right ventricle.