The contractile function of isolated cardiac myocytes is modulated by cytokines through activation of the neutral sphingomyelinase pathway and by NO-mediated blunting of β-adrenergic signaling.[33,34] Pro-inflammatory cytokines may also promote diastolic heart failure through down-regulation of diastolic calcium reuptake by sarcoplasmic reticulum.[35] However, in our study only hs-CRP was associated with an increased risk for diastolic dysfunction. Here, SMPD2 is linked to diastolic heart failure.