It provides a quantitative evaluation of ventricular global and regional function that has been linked to the extent of myocardial fibrosis and is a better predictor of mortality and adverse CV events in a range of conditions particularly when EF is within normal range.16, 17, 18, 19 We showed a very small reduction in GLS over time in the absence of a change in LV mass, systolic blood pressure, or BNP, but acknowledged that the values remain within the normal range and this finding is of questionable significance in this small cohort. This evidence concerns the gene NPPB and Myocardial fibrosis.