ECH1 and miotic rate: The expressions of ACADM (2.49 ± 0.34 vs. 1.43 ± 0.09, P = 0.016) and ECH1 (2.84 ± 0.30 vs. 1.70 ± 0.27, P = 0.034) proteins in the left atria were significantly up-regulated in the MR patients with heart failure (n = 10) compared to normal controls (n = 4; 49-year-old African American male, 60-year-old Caucasian female and 62-year-old Caucasian female, purchased from BioChain, Newark, CA, USA and 35-year-old Asian female, purchased from G-bioscience, St Louis, MO, USA) (Fig. 2).