This supports previous reports describing TPM1 as an important early-onset DCM gene.15,16 Of note, protein-altering variants in NEXN and in ACTC1 were also carried primarily by pediatric patients (NEXN, 6 of 7 and ACTC1, 5 of 6 carriers), although the prevalence was not significantly different in adults vs children after correcting for multiple testing. This evidence concerns the gene TPM1 and familial dilated cardiomyopathy.