A rare autosomal dominant myopathy with associated dilated cardiomyopathy and both central and minicores on muscle biopsy has been attributed to mutations in the skeletal muscle α-actin (ACTA1) gene [74], whereas autosomal recessive mutations in the titin (TTN) gene were recently identified in a novel early-onset myopathy with minicores, increased central nuclei, dystrophic features and a fatal cardiomyopathy [75]. The gene discussed is ACTA1; the disease is dilated cardiomyopathy.