NPPA and familial dilated cardiomyopathy: Dilated cardiomyopathy (DCM) is a type of HCM and contributes to heart fibrosis (Inagaki et al., 2008 ▶). It is manifested by enhancement of cardiac mass, and protein synthesis rate, sarcomeric reorganization, and activation of atrial natriuretic peptide, brain natriuretic peptide, β-myosin heavy chain, and skeletal α-actin.