There is compelling evidence that TGFβ1 plays a critical role in various cardiac pathologies involved in heart failure [29]; however, in contrast to decreased TGFβ1 levels in KD, increased TGFβ1 levels have been found in the myocardium of human patients with idiopathic hypertrophic cardiomyopathy [30], atherosclerotic, and restenotic lesions [31]. LTBP3 forms a complex with TGFβ1 protein, and may be involved in the TGFβ1/SMAD3 pathway as a TGFβ1 target gene [32]. Here, SMAD3 is linked to heart failure.