The expression of ECH1 protein (2.07 ± 0.30 vs. 1.70 ± 0.27, P = 0.670) in the left atria was up-regulated in the patients with aortic valve disease and heart failure (n = 6) compared to normal controls (n = 4), although the difference did not reach statistical significance. This evidence concerns the gene ECH1 and heart failure.