CF transformation into myofibroblasts is primarily promoted by transforming growth factor-β1 (TGF-β1), cytokines, the ECM and other growth factors, which result in the excessive production of ECM and the expression or secretion of growth factors; in the long term, the CFs become maladaptive and lead to abnormal myocardial stiffness, and ultimately, cardiac dysfunction (17,18). The gene discussed is TGFB1; the disease is cystic fibrosis.