Objective: To investigate cytokine gene expression in patients with aortic valve stenosis(AS) and with idiopathic dilated cardiomyopathy(DCM), and to correlate wall stress with myocardial proinflammatory cytokine gene expression. Methods: Human left ventricular(LV) myocardial biopsies were obtained for subsequent reverse transcription polymerase chain reaction of tumour necrosis factor α(TNFα), interleukin(IL)-1β, and IL-6 mRNA. The study population consisted of 24 patients with AS and 10 patients with idiopathic DCM. Results: Patients with AS had a larger ejection fraction(56(5) v 37(4)%, p< 0.01), smaller LV end diastolic volumes(146(11) v 267(21) ml, p< 0.01), and lower end systolic wall stress(44(7) v 112(11)kdyn/cm2, p< 0.001). Upregulation of TNFα, IL-1β, and IL-6 gene expression was detected in both groups. However, TNFαgene expression was significantly higher in AS than in DCM(p=0.009). No correlation was found between haemodynamic parameters and TNFαgene expression. In patients with AS there was a strong inverse relation between circulating TNFαand TNFαgene expression(r=-0.685, p=0.014), between circulating TNFαand IL-1βgene expression(r=-0.664, p=0.018), and between soluble TNF receptor 2 and TNFαgene expression(r=-0.685, p=0.020). Myocardial gene expression of TNFαwas significantly higher in patients with well compensated AS than in patients with decompensated AS(p=0.017). Similarly, patients with decompensated DCM were characterised by significantly lower TNFαgene expression than were patients with well compensated DCM(p=0.011). Conclusion: TNFαgene expression is significantly higher in patients with pressure overload than in normal hearts, in patients with idiopathic DCM, and in patients with compensated versus decompensated heart failure. Secondly, in patients with AS proinflammatory cytokine gene expression did not affect systolic performance. The higher TNFαgene expression in patients with compensated heart failure suggests that cytokine gene expression has an adaptive role in the early phase of LV remodelling. Objective: To investigate cytokine gene expression in patients with aortic valve stenosis (AS) and with idiopathic dilated cardiomyopathy (DCM), and to correlate wall stress with myocardial proinflammatory cytokine gene expression. Methods: Human left ventricular (LV) myocardial biopsies were obtained for subsequent reverse transcription polymerase chain reaction of tumor necrosis factor α (TNFα), interleukin (IL) -1β, and IL-6 mRNA. The study population consisted of 24 patients with AS and 10 patients with idiopathic DCM. Results: Patients with AS had smaller LV end diastolic volumes (146 (11) v267 (21) ml, p <0.01), and lower end systolic wall stress (56 However, TNFαgene expression was significantly higher in AS than in DCM (44 (7) v 112 (11) kdyn / cm2, p <0.001) (p = 0.009). No correlation was found between haemodynamic parameters and TNFαgene expression. In patients with AS there was a strong in relation between circulating TNFαand TNFαgene expression (r = -0.685, p = 0.014), between circulating TNFαand IL-1βgene expression (r = -0.664, p = 0.018) TNFαgene expression (r = -0.685, p = 0.020). Myocardial gene expression of TNFα was significantly higher in patients with well compensated AS than in patients with decompensated AS (p = 0.017). Similarly, patients with decompensated DCM were characterized by significantly lower TNFαgene Expression than were patients with well compensated DCM (p = 0.011). Conclusion: TNFαgene expression is significantly higher in patients with pressure overload than in normal hearts, in patients with idiopathic DCM, and in patients with compensated versus decompensated heart failure. Secondly, in patients with AS proinflammatory cytokine gene expression did not affect systolic performance. The higher TNFαgene expression in patients with compensated heart failure suggests that cytok ine gene expression has an adaptive role in the early phase of LV remodeling.