CS and nonischemic cardiomyopathy: In contrast, CS activity was unaltered in animal models of nonfailing pressure overload.13,34 The 30% fall in median CS activity in the SevAS-rEF group has no strictly comparable human studies, but in human nonischemic cardiomyopathy both reduced37–39 and unchanged activity/expression40 have been observed, as has an increase in CS expression after LV assist device implantation.41 This suggests that reduced oxidative capacity is also an important consideration in the transition to failure in SevAS.