Objective    To investigate the effects of valsartan and  perindopril on serum cytokine levels and myocardial fibrosis in patients with chronic heart failure of dilated cardiomyopathy(DCM).     Methods    Serum concentrations of TNF-α

IL-6

TGF-β1 and serum procollagen Ⅲ peptide (PCⅢ)

laminin(LN)

hyaluronic acid(HA) in normal controls (n=30) and patients with CHF resulting from DCM (n=30)

who were randomized into valsartan group (n=15) and perindopril group (n=15)

were measured before and 3 months after treatment respectively. Left ventricular ejective fractions(LVEF) were also estimated in those subjects.     Results    There was a significant increase in serum levels of TNF-α

IL-6 and PCⅢ

LN

HA in patients with CHF compared with normal controls(P0.01) while the serum levels of TGF-β1 decreased (P0.01). The serum levels of TNF-α

IL-6 and PCⅢ

LN

HA were negative related to LVEF but TGF-β1 was positive related to LVEF. There was a significant decrease in serum levels of TNF-α

IL-6 and PCⅢ

LN

HA and increase in TGF-β1 and LVEF in both valsartan group and perindopril group

but the changes in the valsartan group was more visible. The increasing of cardiac function and the decreasing of myocardial fibrosis have some relationship.     Conclusion    There is a disequilibrium in the levels of serum concentrations including TNF-α

IL-6 and TGF-β1 and a significant increase in serum levels of PCⅢ

LN

HA in patients with CHF of DCM

and the serum levels of cytokine and myocardial fibrosis are related to LVEF.  Valsartan or perindopril adjusts the balance of the serum levels of cytokine and ameliorated myocardial fibrosis and LVEF but the effect of valsartan is more visible.