A clinical study of >4500 patients with HCM enrolled in the SHaRe showed that participants with pathogenic variants in sarcomere protein genes had the highest rates of heart failure and atrial fibrillation.14 However, many human MYH7 missense variants that are identified in patients with HCM cannot be definitively classified as pathogenic or benign and are designated VUS. Here, MYH7 is linked to heart failure.