Introduction: Determination of the pathophysiological role of proinflammatory cytokines – IL-1b, IL-6 and TNF-alpha in CHF in children secondary to congenital systemic-to-pulmonary shunts complicated with PAH of different degree. Methods: The study – 70 children: 0.5 months – 18 years with CHF secondary to systemic-pulmonary shunts simple, compound and complex with PAH (anatomical and pathophysiological classification, modified from Venice 2003 SEC HTPA Guide 2009). Depending on the degree of PAH, patients were divided into 2: group I – 16 children with CHF and moderate PAH (PSAP 50 – 70% of the systemic) and group II – 54 children with CHF and PAH severe degree (PSAP > 70% of the systemic). After CF NYHA/Ross, in the group I prevailed children with CF II and III, and in the second – CF III and IV (p < 0.001). The control group 10 kids basically healthy with innocent heart murmur. The groups were comparable by age and sex. Proinflammatory cytokines were determined by analysis – immunoferment screening method. Results: At the patients in group I of the study the serum level of IL-1b was 3.71 ± 0.37 pg/ml vs 10.49 ± 1.56 in the second group (p < 0.05) and 2.74 ± 0.53 healthy children (p < 0.05, p < 0.001). The amount of IL-6 was 5.5 ± 0.83 pg/ml in group I versus 8.61 ± 0.83 in group II (p = 0.05) and 1.63 ± 0.62 in healthy (p < 0.001). TNF-alpha level was 3.62 ± 0.37 in group I compared with 6.88 ± 0.9 in group II (p > 0.05) and in healthy controls – 1.82 ± 0.91 pg/ml (p < 0.05, p < 0.001). Conclusions: Proinflammatory cytokines – IL-1b, IL-6 and TNF-alpha are relevant to the pathophysiology of CHF secondary to congenital shunts associated with PAH, their levels increasing with the severity of this pathology – FC HYHA/ROSS of CHF and level of PAH.