PPCM, on the other hand, results from development of primary myocardial dysfunction leading to congestive heart failure [3,4], and has been shown recently, in a mouse model, to be associated with defective cathepsin-D mediated cleavage of prolactin into a 16-kDa form, which is both pro-apoptotic and anti-angiogenic [31]. The gene discussed is CTSD; the disease is congestive heart failure.